Individual
DR. MARK ROBERT JABBUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4505 144TH AVE SE, BELLEVUE, WA 98006-2324
(425) 747-1059
Mailing address
4505 144TH AVE SE, BELLEVUE, WA 98006-2324
(425) 747-1059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
55963-020
WI
207Q00000X
Family Medicine Physician
6721
AK
207Q00000X
Family Medicine Physician
Primary
MD00015223
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750801
—
WA
Enumeration date
05/04/2007
Last updated
08/17/2011
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