Holmberg, Mark R

Holmberg, Mark R is an individual health care provider with primary practice located at 1100 9Th Ave , Seattle WA 98101-2756. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Holmberg, Mark R can be contacted via phone (206) 223-6980.

Contact Information

Primary practice address
1100 9Th Ave Seattle WA 98101-2756
Phone: (206) 223-6980
Fax: (206) 223-6982
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R 154503-0 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP30007744 Washington

Profile Details

NPI number 1790763233
LBN Legal business name Holmberg, Mark R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Mar 12th, 2015 - about 11 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 1790763233 NPPES
Washington Other 5069HO BLUE SHIELD #
Washington Other RNA0011 BLUE SHIELD #
Washington Other P00444040 BLUE SHIELD #
Washington MEDICAID 9653981 BLUE SHIELD #

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