Dedomenico, Mark
Dedomenico, Mark is an sole proprietor health care provider with primary practice located at 4455 148Th Ave Ne , Bellevue WA 98007-3120. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Dedomenico, Mark can be contacted via phone (425) 867-5175.Contact Information
Primary practice address
4455 148Th Ave Ne
Bellevue WA 98007-3120
Phone: (425) 867-5175
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD00011381 | Washington |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 27531 | California |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 29548 | Missouri |
Profile Details
| NPI number | 1760737654 |
|---|---|
| LBN Legal business name | Dedomenico, Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2012 |
| Last updated | Jul 17th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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