DOUGLAS MARCUM (NPI# 1154373116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154373116 |
| Entity Type | Individual |
| Full Name | DOUGLAS MARCUM |
| Credential | PA-C |
| Practice Address |
Mamc Tacoma WA 98433 |
| Mailing Address |
2310 Worthington St Steilacoom WA 98388-3454 |
| Practice Telephone | 2539680433 |
| Mailing Telephone | 2453589264 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10003396 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
MAMC |
| City | TACOMA |
| State | WA |
| Zip Code | 98433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992785604 | Anne Mercita Mitzak | Nurse Anesthetist, Certified Registered | Mamc, Bldg 9040 Fitzsimmons Drive, Tacoma, WA 98431-0001 | 2006-01-19 |
| 1487053989 | Adam Garcia-manfredi | Optometrist | Mamc, Optometry, Tacoma, WA 98431-0001 | 2014-08-20 |
| 1710008354 | Michelle Lee Kline | Student in an Organized Health Care Education/Training Program | Mamc, Tacoma, WA 98431-0001 | 2007-04-02 |
| 1184720344 | Lisa Konitzer | Specialist | Mamc, Tacoma, WA 98431 | 2006-09-15 |
| 1104896836 | Andrew Richard Wiesen | Internal Medicine | Mamc, Attn: Mchj-pv (ltc Wiesen), Tacoma, WA 98431-0001 | 2006-01-25 |
| 1487624508 | Daniel Mark Wenzell | Anesthesiology | Mamc, Bld 9040a, Fitzsimmons Ave, Tacoma, WA 98431-0001 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739881 | Bryonna Floyd | Dental Assistant | 11572 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2020-08-07 |
| 1790393213 | Matthew T Ellison | Dentist | Dental Clinic 2, 3740 South 14th St., Joint Base Lewis-mcchord, WA 98433 | 2020-07-21 |
| 1952933251 | Julie Kristen Dutler | Dental Hygienist | 11572 C St, Jblm, WA 98433 | 2020-02-05 |
| 1881224806 | James Eric Carvelli | Dental Assistant | 11572 17th Street & C Street, Joint Base Lewis Mcchord, WA 98433 | 2020-01-17 |
| 1245891019 | Tanya Latrell Lesane | Counselor | 9924b W. Johnson St, Joint Base Lewis0mcchord, WA 98433 | 2019-06-24 |
| 1740844224 | Allison Tracy Bertoni | Student in an Organized Health Care Education/Training Program | 3740 South 14th Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-30 |
| 1124682448 | Lori Ann Sage | Registered Nurse | Building 11582, 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-23 |
| 1639645997 | Emily Elisabeth Armstrong | Emergency Medical Technician, Paramedic | 3370 Evergreen Ave, Jblm, WA 98433 | 2018-10-15 |
| 1982182101 | Won Kyung Yang | Dentist | 11582 C St., Jblm, WA 98433 | 2018-07-31 |
| 1205325966 | Gloria Judith Penate I | Dental Hygienist | 2103 North Division Street, Tacoma, WA 98433 | 2018-05-08 |
| Find all providers in zip 98433 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| 1790177731 | Taylor Marquardt | Physician Assistant | 1624 S I St Ste 305, Tacoma, WA 98405-5093 | 2015-02-27 |
| 1134540909 | Otis Lawrence | Physician Assistant | 608 E 62nd St, Tacoma, WA 98404-1935 | 2013-12-22 |
| 1689905788 | Jason F Naylor | Physician Assistant | 9040 Jackson Avenu, Tacoma, WA 98431-7037 | 2010-01-29 |
| 1952536146 | Eric Vangsnes | Physician Assistant | 9040 Reid St., Attn: Mchj-qcr, Tacoma, WA 98431-1100 | 2009-05-18 |
| 1801048731 | Anthony Cee Charles | Physician Assistant | 1307 Martin Luther King Jr Way, Tacoma, WA 98405-3929 | 2008-10-22 |
| 1083742480 | Darin W Smith | Physician Assistant | 1623 E J St, Tacoma, WA 98421-1602 | 2007-02-28 |
| 1417045857 | Kenneth Leo Fleck | Physician Assistant | 910 Tacoma Ave S, Tacoma, WA 98402-2104 | 2006-10-11 |
| 1912924366 | Marthe Butzen | Physician Assistant | 1708 E. 44th Street, Tacoma, WA 98404 | 2006-07-15 |
| 1013973205 | Sheldon Burdell Watson | Physician Assistant | Madigan Army Medical Center/okubo Clinic, 9040 Jackson Ave, Tacoma, WA 98431-1730 | 2006-04-25 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.