Basic Information
Provider Information
NPI: 1639144728
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARKEL
FirstName: THOMAS
MiddleName: OWEN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19020 33RD AVE W
Address2: STE 210
City: LYNNWOOD
State: WA
PostalCode: 980364748
CountryCode: US
TelephoneNumber: 4255631500
FaxNumber: 4255631374
Practice Location
Address1: 2211 NE 139TH ST
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986862742
CountryCode: US
TelephoneNumber: 3605664840
FaxNumber: 3605664842
Other Information
ProviderEnumerationDate: 02/22/2006
LastUpdateDate: 10/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X41697TNN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD60953088WAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085B0100XMD60953088WAY Allopathic & Osteopathic PhysiciansRadiologyBody Imaging

ID Information
IDTypeStateIssuerDescription
044015801WAL & I - RADIAOTHER
044015601WAL & I - RADIAOTHER
044016001WAL & I - SWEDISH RADIAOTHER
044016901WAL & I - SEATTLE RADIOLOGYOTHER
044017101WAL & I - VANCOUVER RADIOLOGISTSOTHER
044016301WAL & I - EVERGREEN RADIAOTHER
413730501 BCBSOTHER
218185205WA MEDICAID
044016601WAL & I - SOUTH SOUND RADIOLOGYOTHER
413863801 BCBSOTHER


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