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Individual

DR. MARK DERCHUEN LO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4800 SAND POINT WAY NE, M/S B5520, SEATTLE CHILDREN'S HOSPITAL, SEATTLE, WA 98105
(206) 987-2599
Mailing address
4800 SAND POINT WAY NE, M/S B5520, SEATTLE CHILDREN'S HOSPITAL, SEATTLE, WA 98105
(206) 987-2599

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A99569
CA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD60095154
WA

Other

Enumeration date
05/18/2007
Last updated
05/31/2011
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