Provider Demographics
NPI:1447384292
Name:ELGEE, MARK (LAC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ELGEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 SW ROSE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-2337
Mailing Address - Country:US
Mailing Address - Phone:206-778-2213
Mailing Address - Fax:206-778-2213
Practice Address - Street 1:3915 SW ROSE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-2337
Practice Address - Country:US
Practice Address - Phone:206-778-2213
Practice Address - Fax:206-778-2213
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist