Individual
MARK YOUNGBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS-IV
Contact information
Practice address
1959 NE PACIFIC ST, BOX 356540, BB-1440 HSB, SEATTLE, WA 98195-6540
(206) 543-2773
(206) 543-2958
Mailing address
1959 NE PACIFIC ST, BOX 356540, BB-1440 HSB, SEATTLE, WA 98195-6540
(206) 543-2773
(206) 543-2958
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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