Provider Demographics
NPI:1225198708
Name:MARKUS, STEPHEN PETER (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PETER
Last Name:MARKUS
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 1:1935 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033
Mailing Address - Country:US
Mailing Address - Phone:425-644-6048
Mailing Address - Fax:425-641-2721
Practice Address - Street 1:1560 140TH AVE NE
Practice Address - Street 2:#203
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-644-6048
Practice Address - Fax:425-641-2721
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021837207Q00000X, 207QA0401X
CAG1535342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA12413OtherL & I
D33718Medicare UPIN
WA12413OtherL & I