Provider Demographics
NPI:1376369769
Name:URIARTE MAYORGA, MARCELO HUGO (MD FACS)
Entity type:Individual
Prefix:
First Name:MARCELO
Middle Name:HUGO
Last Name:URIARTE MAYORGA
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15028 45TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-2248
Mailing Address - Country:US
Mailing Address - Phone:425-328-8497
Mailing Address - Fax:
Practice Address - Street 1:15028 45TH PL W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-2248
Practice Address - Country:US
Practice Address - Phone:425-328-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program