Provider Demographics
NPI:1184849804
Name:TWYMAN, MARIANNE L (MD)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:L
Last Name:TWYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E. MADISON
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2959
Mailing Address - Country:US
Mailing Address - Phone:206-328-7722
Mailing Address - Fax:206-720-4657
Practice Address - Street 1:2001 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2959
Practice Address - Country:US
Practice Address - Phone:206-328-7722
Practice Address - Fax:206-720-4657
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8343303Medicaid
WABT7028384OtherDEA
WABT2834768OtherDEA
WABT5929940OtherDEA
WABT7028384OtherDEA