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Individual

DR. MARC D PELLICCIARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12729 NORTHUP WAY STE 6, BELLEVUE, WA 98005-1935
(425) 467-1000
(425) 467-0100
Mailing address
12729 NORTHUP WAY STE 6, BELLEVUE, WA 98005-1935
(425) 467-1000
(425) 467-0100

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
MD 00036813
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD2652
AK
Enumeration date
11/16/2006
Last updated
04/17/2019
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