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General NPI Number Information
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NPI Number | 1356875736
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Entity Type | Individual
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Provider Name | MARION ARTHUR FOSSUM MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 1717 S RITCHEY RD
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City | MEDICAL LAKE
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State | WA
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Zip | 99022-8792
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Country | US
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Telephone | 509-590-8766
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 S RITCHEY RD
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City | MEDICAL LAKE
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State | WA
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Zip | 99022-8792
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Country | US
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Telephone | 509-590-8766
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 33801
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 83574-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2024012104
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 61254901
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2024-00610
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 26243
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 61254901
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME167370
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0101281448
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License Number State | VA
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Taxonomy #10
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA12260400
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License Number State | NJ
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Taxonomy #11
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | 61254901
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License Number State | WA
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Taxonomy #12
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036.169354
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License Number State | IL
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Taxonomy #13
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD220784
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License Number State | OR
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Taxonomy #14
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 01092935A
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License Number State | IN
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