Individual provider · Type 1 NPI

Mark O. Fosdal, PA C

Medical Physician Assistant · Seattle, WA

NPI number 1427262245 Active

Practice location

825 Eastlake Ave E
Seattle, WA 98109-4405

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA10003666 (WA)

Medical Physician Assistant: Definition to come...

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About NPI 1427262245

Mark O. Fosdal, PA C's National Provider Identifier is 1427262245, issued on May 10, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Seattle, WA. The record was last updated on Jul 9, 2007.