Individual
DR. MARC R MAYBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1959 NE PACIFIC ST BOX 356165, SEATTLE, WA 98195-5788
(206) 598-7226
(206) 598-2475
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 542-6420
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD00022792
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0189724
LABOR AND INDUSTRIES
WA
05
—
1009224
—
WA
05
—
1710046511
—
WA
Enumeration date
12/07/2006
Last updated
07/21/2022
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