Pellicciaro, Marc D

Pellicciaro, Marc D is an individual health care provider with primary practice located at 12729 Northup Way Ste 6 , Bellevue WA 98005-1935. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Pellicciaro, Marc D can be contacted via phone (425) 467-1000.

Contact Information

Primary practice address
12729 Northup Way Ste 6 Bellevue WA 98005-1935
Phone: (425) 467-1000
Fax: (425) 467-0100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X MD 00036813 Washington

Profile Details

NPI number 1962575951
LBN Legal business name Pellicciaro, Marc D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Apr 17th, 2019 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962575951 NPPES
Alaska MEDICAID MD2652

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