Active NPI
Mark Jeffrey Rosenberg, MD
- Specialist
- Sedro Woolley, WA
National Provider Identifier
1740467596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD00020570
- Practice address
- 2031C Hospital Drive
Sedro Woolley, WA 98284 - Phone
- (360) 856-4700
- Fax
- (360) 856-9080
- NPI assigned
- Jan 23, 2008
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MD00020570 | WA | Primary |
Addresses
Primary practice location
2031C Hospital Drive
Sedro Woolley, WA 98284
Mailing address
1660 S Columbian Way
Outpatient Mental Health
Seattle, WA 98108-1532
Phone (360) 856-4700
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00020570 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1740467596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"address_2": "OUTPATIENT MENTAL HEALTH",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "360-856-4700",
"fax_number": "360-856-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2031C HOSPITAL DRIVE",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "98284",
"telephone_number": "360-856-4700",
"fax_number": "360-856-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "MARK",
"middle_name": "JEFFREY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-23",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00020570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedro Woolley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.