Provider Demographics
NPI:1558440453
Name:GREENBAUM, MARIANNE CLARE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:CLARE
Last Name:GREENBAUM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:STE 210
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 1:1229 MADISON STREET
Practice Address - Street 2:SUITE 1150
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3587
Practice Address - Country:US
Practice Address - Phone:206-386-6300
Practice Address - Fax:206-386-6316
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2021-09-29
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Provider Licenses
StateLicense IDTaxonomies
WAMD000370292085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0439517OtherL & I - SWEDISH RADIA EDMONDS
WA0439519OtherL & I - EVERGREEN RADIA
WA0439514OtherL & I - RADIA
WA0439515OtherL & I - RADIA KING
WA0439520OtherL & I - SOUTH SOUND RADIOLOGY
WA0439521OtherL & I - SEATTLE RADIOLOGY
WA0439522OtherL & I - VANCOUVER RADIOLOGISTS
WA8242273Medicaid
WA1013281Medicaid
WA135338OtherL & I