Provider Demographics
NPI:1427168483
Name:HILL, MARK E (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 S LUCILE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2530
Mailing Address - Country:US
Mailing Address - Phone:206-617-9210
Mailing Address - Fax:
Practice Address - Street 1:5133 S LUCILE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2530
Practice Address - Country:US
Practice Address - Phone:206-617-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028963208D00000X, 208G00000X
WA000289632083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHI7841OtherBLUE SHIELD
WA8890877OtherMEDICARE PTAN - KITSAP CO
WAUS0864641OtherAETNA/USHC SPECIALIST
WA805370700OtherIDAHO MEDICAID
WA8205189Medicaid
WAMD8963OtherALASKA MEDICAID
WA0039625OtherLABOR & INDUSTRY
060042767OtherRAILROAD MEDICARE
G30231Medicare UPIN
WAHI7841OtherBLUE SHIELD