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General NPI Number Information
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NPI Number | 1346550266
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Entity Type | Organization
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Legal Business Name | MARVIN M BROOKE MD
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 801 PINE ST STE 100
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City | SEATTLE
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State | WA
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Zip | 98101-1852
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Country | US
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Telephone | 206-302-7747
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Fax | 206-302-7748
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Provider Business Mailing Address
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Address Line | 801 PINE ST STE 100
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City | SEATTLE
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State | WA
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Zip | 98101-1852
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Country | US
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Telephone | 206-302-7747
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Fax | 206-302-7748
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Authorized Official
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Title or Position | OWNER
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Name | MARVIN M BROOKE
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Credential | MD
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Telephone | 206-302-7747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD00015202
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License Number State | WA
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