Individual
MARK D HEGEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34612 6TH AVE S, SUITE 200, FEDERAL WAY, WA 98003-8723
(253) 661-2594
(253) 661-2694
Mailing address
34612 6TH AVE S, SUITE 200, FEDERAL WAY, WA 98003-8723
(253) 661-2594
(253) 661-2694
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD00025475
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1056662
—
WA
01
—
1427128198
GROUP NPI
WA
Enumeration date
06/06/2006
Last updated
12/29/2011
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