DR. MARK DERCHUEN LO (NPI# 1649488123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649488123 |
| Entity Type | Individual |
| Full Name | DR. MARK DERCHUEN LO |
| Credential | M.D. |
| Practice Address |
4800 Sand Point Way Ne, M/s B5520 Seattle Children's Hospital Seattle WA 98105 |
| Practice Telephone | 2069872599 |
| Mailing Telephone | 2069872599 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2011-05-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | A99569 | CA | Allopathic & Osteopathic Physicians |
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
MD60095154 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578515391 | Mark Gau Man Lo | Psychiatry & Neurology | 3102 East Highland Ave, Patton, CA 92369 | 2006-05-17 |
| Street Address |
4800 SAND POINT WAY NE, M/S B5520 SEATTLE CHILDREN'S HOSPITAL |
| City | SEATTLE |
| State | WA |
| Zip Code | 98105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1427688845 | Daniela Michell Zepeda | Behavioral Analyst | 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 | 2020-01-24 |
| 1255981189 | Emily King | Student in an Organized Health Care Education/Training Program | Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 | 2019-09-12 |
| 1821659327 | Sara Katherine Horne | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 | 2019-06-25 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1487117891 | Nirupama Madhavan | Behavioral Analyst | 5001 25th Ave Ne, Seattle, WA 98105 | 2019-04-11 |
| 1780155648 | Eryn R Mcentee | Naturopath | 2216 Ne46th St, Seattle, WA 98105 | 2018-12-17 |
| 1356811921 | Kyle Leland Bernbach | Massage Therapist | 5224 Ravenna Ave Ne, Seattle, WA 98105 | 2018-11-27 |
| 1548742380 | Janal Kim | Physician Assistant | 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 | 2018-08-29 |
| Find all providers in zip 98105 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023403698 | Siobhan Thomas-smith | Pediatrics | 4800 Sand Point Way Ne # Oc.7830, Seattle, WA 98105 | 2015-04-01 |
| 1700299856 | Alexander M Stephan | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2014-06-06 |
| 1770920381 | William Benjamin Prince | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2013-05-23 |
| 1578838751 | Ashley Elizabeth Keilman | Pediatrics | 4800 Sand Point Way Ne # A-5950, Seattle, WA 98105 | 2012-03-20 |
| 1932408119 | Hiromi Yoshida | Pediatrics | 4800 Sand Point Way Ne, Mb.7.520, Seattle, WA 98105 | 2011-03-27 |
| 1861710568 | Anita Anne Thomas | Pediatrics | 4800 Sand Point Way Ne, Mb.7.520, Seattle, WA 98105-3901 | 2010-05-06 |
| 1912149527 | Anne C Slater | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2009-03-27 |
| 1093973083 | Lori Ellen Rutman | Pediatrics | 4800 Sand Point Way Ne, M/s Mb.7.520, Seattle, WA 98105-3901 | 2008-05-28 |
| 1730376518 | Brian Hyun Park | Pediatrics | 747 Broadway, Seattle, WA 98122-4379 | 2007-09-26 |
| 1891828943 | Norma Jean Haulman | Pediatrics | 315 E Stevens Cir, Seattle, WA 98195-0001 | 2007-03-14 |
| Find all providers in SEATTLE | ||||
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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.