Healthcare Provider Details

I. General information

NPI: 1215033915
Provider Name (Legal Business Name): MARCUS COLYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 NW MAPLE ST STE 202
ISSAQUAH WA
98027-8127
US

IV. Provider business mailing address

1740 NW MAPLE ST STE 202
ISSAQUAH WA
98027-8127
US

V. Phone/Fax

Practice location:
  • Phone: 425-900-6222
  • Fax: 425-249-3166
Mailing address:
  • Phone: 425-900-6222
  • Fax: 425-249-3166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD61305286
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD61305286
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: