Healthcare Provider Details

I. General information

NPI: 1407886468
Provider Name (Legal Business Name): GENIE M MARKWELL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19987 1ST AVE S STE 102
NORMANDY PARK WA
98148-2400
US

IV. Provider business mailing address

19987 1ST AVE S STE 102
NORMANDY PARK WA
98148-2400
US

V. Phone/Fax

Practice location:
  • Phone: 206-824-7200
  • Fax: 206-832-4652
Mailing address:
  • Phone: 206-824-7200
  • Fax: 206-832-4652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00034082
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: