Provider Demographics
NPI:1720003973
Name:SPECK, SARAH MARSHALL (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARSHALL
Last Name:SPECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW MARKET ST STE 408
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3901
Mailing Address - Country:US
Mailing Address - Phone:206-466-5936
Mailing Address - Fax:206-466-5984
Practice Address - Street 1:1801 NW MARKET ST STE 408
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3901
Practice Address - Country:US
Practice Address - Phone:206-466-5936
Practice Address - Fax:206-466-5984
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016855207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0209225OtherL & I
WA1099993Medicaid
WA1099993Medicaid
WAA05684Medicare UPIN