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Individual

DR. MARK STEPHEN JUSTUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
533 S 336TH ST, SUITE C, FEDERAL WAY, WA 98003-6329
(253) 661-1700
(253) 661-4565
Mailing address
533 S 336TH ST, SUITE C, FEDERAL WAY, WA 98003-6329
(253) 661-1700
(253) 661-4565

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036-103064
IL
2085R0202X
Diagnostic Radiology Physician
Primary
MD00046833
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8460149
WA
Enumeration date
07/25/2006
Last updated
02/29/2012
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