Provider Demographics
NPI:1396898086
Name:PIKER, MARK K (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:K
Last Name:PIKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4140 FACTORIA BLVD SE
Mailing Address - Street 2:STE A
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5261
Mailing Address - Country:US
Mailing Address - Phone:425-655-0700
Mailing Address - Fax:425-655-0800
Practice Address - Street 1:4140 FACTORIA BLVD SE STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5261
Practice Address - Country:US
Practice Address - Phone:425-655-0700
Practice Address - Fax:425-655-0800
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000463532084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAI69778Medicare UPIN