Individual
MARC J LACRAMPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00038162
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039587
LABOR & INDUSTRY
WA
01
—
300111011
RAILROAD MEDICARE
WA
01
—
806360500
IDAHO MEDICAID
WA
05
—
8252637
—
WA
01
—
LA0194
BLUE SHIELD
WA
01
—
MD330W
ALASKA MEDICAID
WA
01
—
US2272422
AETNA/USHC SPECIALIST
WA
Enumeration date
07/31/2006
Last updated
05/18/2011
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