Active NPI
Marvin A Wayne, MD
- Emergency Medicine Physician
- Bellingham, WA
National Provider Identifier
1619903051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD00013140
- Practice address
- 2901 Squalicum Pkwy
Bellingham, WA 98225-1851 - Phone
- (360) 734-5400
- Fax
- (360) 738-6377
- NPI assigned
- Jun 25, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00013140 | WA | Primary |
Addresses
Primary practice location
2901 Squalicum Pkwy
Bellingham, WA 98225-1851
Mailing address
505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0168210 | Other | WA | LIWA |
| 4872WA | Other | WA | BSWA |
| 1920404 | Medicaid | WA |
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 |
|---|---|---|---|
| MD00013140 | WA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Physician Associates, Apc | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Federal Way, WA
- NPI 1407127442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1619903051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S 336TH ST",
"address_2": "SUITE 600",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036328",
"telephone_number": "253-838-6180",
"fax_number": "253-838-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 SQUALICUM PKWY",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251851",
"telephone_number": "360-734-5400",
"fax_number": "360-738-6377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAYNE",
"first_name": "MARVIN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD00013140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0168210",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "4872WA",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1920404",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.