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Individual

MARK DAMBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
13231 SE 36TH ST, SUITE 110, BELLEVUE, WA 98006-7321
(425) 957-9000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60205692
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1952606477
WA
Enumeration date
01/13/2011
Last updated
09/19/2013
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