Provider Demographics
NPI: | 1942520366 |
---|---|
Name: | MARK H TSENG MD PC |
Entity Type: | Organization |
Organization Name: | MARK H TSENG MD PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARK |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | TSENG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 253-804-2809 |
Mailing Address - Street 1: | 121 N DIVISION ST |
Mailing Address - Street 2: | SUITE 300 |
Mailing Address - City: | AUBURN |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98001-4931 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 253-736-2818 |
Mailing Address - Fax: | 888-801-8031 |
Practice Address - Street 1: | 121 N DIVISION ST |
Practice Address - Street 2: | SUITE 300 |
Practice Address - City: | AUBURN |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98001-4931 |
Practice Address - Country: | US |
Practice Address - Phone: | 253-736-2818 |
Practice Address - Fax: | 888-801-8031 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-06-08 |
Last Update Date: | 2016-12-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | MD60125808 | 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Single Specialty |