Individual
MARK T GROUDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4100
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD00018005
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231115
L&I
WA
01
—
1180
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
1912082710
—
WA
Enumeration date
10/27/2006
Last updated
02/20/2013
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