Provider Demographics
NPI:1235103953
Name:ZOBEL, MARK STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:ZOBEL
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 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030954174400000X, 2085P0229X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
300085552OtherRAILROAD MEDICARE
WA8226839Medicaid
WA353427OtherL&I-EVERGREEN RADIA
WA123016OtherL&I
WA353422OtherL&I-RADIA REST OF WA
WAZO5641OtherREGENCE
WA353423OtherL&I-RADIA KING COUNTY
WA8921795OtherCRIME VICTIMS
WA353426OtherL&I-SWEDISH RADIA
WA1005476Medicaid
5275249OtherAETNA
WAAB04242Medicare PIN
WAP01623663Medicare PIN
WAG8948921Medicare PIN
WAG8949090Medicare PIN
WAZO5641OtherREGENCE
WAG8948931Medicare PIN
WAP01623690Medicare PIN
WA123016OtherL&I
WAP01623673Medicare PIN