Provider Demographics
NPI:1720665524
Name:ZEITZ, MARCUS AARON
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:AARON
Last Name:ZEITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9711 174TH CT NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-8625
Mailing Address - Country:US
Mailing Address - Phone:425-698-0846
Mailing Address - Fax:
Practice Address - Street 1:9710 STATE AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2232
Practice Address - Country:US
Practice Address - Phone:360-657-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program