Healthcare Provider Details

I. General information

NPI: 1154592194
Provider Name (Legal Business Name): MARC ALAN KIRSCHNER, MD, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N 115TH ST SUITE 330
SEATTLE WA
98133-8400
US

IV. Provider business mailing address

1536 N 115TH ST SUITE 330
SEATTLE WA
98133-8400
US

V. Phone/Fax

Practice location:
  • Phone: 206-365-3223
  • Fax: 206-365-2980
Mailing address:
  • Phone: 206-365-3223
  • Fax: 206-365-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00034767
License Number StateWA

VIII. Authorized Official

Name: DR. MARC ALAN KIRSCHNER
Title or Position: PRESIDENT
Credential: MD
Phone: 206-365-3223