Active NPI
Mark Stanley Rundel, L.M.P.
- Rehabilitation Practitioner
- Seattle, WA
National Provider Identifier
1376600668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- MA00006014
- Practice address
- 1605 12TH Ave
Suite 30
Seattle, WA 98122-2467 - Phone
- (206) 324-5744
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | MA00006014 | WA | Primary |
Addresses
Primary practice location
1605 12TH Ave
Suite 30
Seattle, WA 98122-2467
Mailing address
6743 5TH Ave NW
Seattle, WA 98117-5014
Phone (206) 324-5744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00006014 | WA | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376600668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6743 5TH AVE NW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981175014",
"telephone_number": "206-324-5744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 12TH AVE",
"address_2": "SUITE 30",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981222467",
"telephone_number": "206-324-5744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNDEL",
"first_name": "MARK",
"middle_name": "STANLEY",
"name_prefix": "Mr.",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "WA",
"license": "MA00006014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.