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General NPI Number Information
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NPI Number | 1497922108
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Entity Type | Organization
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Legal Business Name | EDMONDS ENDOCRINOLOGY
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 6100 219TH ST SW STE 480
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2222
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Country | US
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Telephone | 425-774-5104
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Fax | 425-778-2620
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Provider Business Mailing Address
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Address Line | 6100 219TH ST SW STE 480
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2222
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Country | US
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Telephone | 425-774-5104
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Fax | 425-778-2620
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Authorized Official
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Title or Position | OWNER
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Name | MARK ALAN SILVER
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Credential | MD
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Telephone | 425-774-5104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD00021572
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License Number State | WA
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