Mark Damberg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60205692 Issued in WA

Practice address

13231 SE 36TH St
Suite 110
Bellevue, WA 98006-7321

Phone

(425) 957-9000

NPI assigned

Jan 13, 2011

Last updated

Sep 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.damberg@70976835354628.direct.elationemr.com

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

• Association of University Physicians

  dba University of Washington Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1093736621
  NPD (past)

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1952606477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13231 SE 36TH ST",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980067321",
            "telephone_number": "425-957-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMBERG",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-13",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60205692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952606477",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muhammad Ismail Dalal, DC
• Susan Jean Dalrymple-Herington
• Lynn A Dalton, LMP
• Heeral Dalwadi, MD
• Michelle Damas
• Nazanin Dameshghi
• Erin Damitio, RBT
• Brook Richmire Damour, RC
• Kalyan Dandala, MD
• Sumedha Dandapanthula

• Physician Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.