Individual
MARK L STURDEVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-6574
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
MD61025436
WA
208600000X
Surgery Physician
Primary
MD61025436
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992894075
—
WA
Enumeration date
10/12/2006
Last updated
11/05/2020
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