Deramo, Mark A
Deramo, Mark A is an individual health care provider with primary practice located at 1806 W Lincoln Ave , Yakima WA 98902-2473. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deramo, Mark A can be contacted via phone (509) 452-4520.Contact Information
Primary practice address
1806 W Lincoln Ave
Yakima WA 98902-2473
Phone: (509) 452-4520
Fax: (509) 452-5224
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00039153 | Washington |
Profile Details
| NPI number | 1205835576 |
|---|---|
| LBN Legal business name | Deramo, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Oct 7th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205835576 | NPPES |
| Washington | MEDICAID | 8405524 | |
| Washington | Other | P00181860 | |
| Washington | Other | 0183345 |
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