Active NPI
Mark Douglas Kline, MD
- Psychiatry Physician
- Seattle, WA
National Provider Identifier
1477670495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 00043234
- Practice address
- 2319 N 45TH St Ste 209
Seattle, WA 98103-6978 - Phone
- (206) 468-9654
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 00043234 | WA | Primary |
Addresses
Primary practice location
2319 N 45TH St Ste 209
Seattle, WA 98103-6978
Mailing address
44930 Morand Drive PMB 114
Caspar, CA 95420-0147
Phone (707) 225-4744
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC03967F | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00043234 | WA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600300800000",
"number": "1477670495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44930 MORAND DRIVE PMB 114",
"city": "CASPAR",
"state": "CA",
"postal_code": "954200147",
"telephone_number": "707-225-4744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2319 N 45TH ST STE 209",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036978",
"telephone_number": "206-468-9654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINE",
"first_name": "MARK",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2020-09-17",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "00043234",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC03967F",
"state": "CA"
}
],
"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 Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.