Provider Demographics
NPI:1215033915
Name:COLYER, MARCUS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:
Last Name:COLYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 NW MAPLE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8127
Mailing Address - Country:US
Mailing Address - Phone:425-900-6222
Mailing Address - Fax:425-249-3166
Practice Address - Street 1:1740 NW MAPLE ST STE 202
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8127
Practice Address - Country:US
Practice Address - Phone:425-900-6222
Practice Address - Fax:425-249-3166
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61305286207WX0107X, 207W00000X
DCMD037084207W00000X, 207WX0107X
VA0101238759207WX0107X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215033915Medicaid
WA2268107Medicaid
MD016593000Medicaid
DC039498400Medicaid