Individual provider Active NPI

Lucas Gomes Marques, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Puyallup, WA
National Provider Identifier
1336842079
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
MD.MD.70111860 Issued in WA
Practice address
11102 Sunrise Blvd E Ste 106
Puyallup, WA 98374-8846
Phone
(253) 848-8797
Fax
(253) 845-1114
NPI assigned
Mar 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD.MD.70111860 WA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD.MD.70111860 WA Primary

Addresses

Primary practice location

11102 Sunrise Blvd E Ste 106
Puyallup, WA 98374-8846

Mailing address

PO Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other practice location 1

4800 Sand Point Way NE # Oc.7830
Seattle, WA 98105-3901
Phone (206) 987-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230428001828 WA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9436514379

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Morehouse School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3458 Parkview PL
Hapeville, GA 30354-1572

PO Box
Suite 5299
Tacoma, WA 98415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Past Accepting new patients
Pediatrix Cardiology of Washington, P.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1336842079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E STE 106",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748846",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-1114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE # Oc.7830",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUES",
        "first_name": "LUCAS",
        "middle_name": "GOMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD.MD.70111860",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD.MD.70111860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.