Provider Demographics
NPI:1174141915
Name:MARKS HEALTH
Entity type:Organization
Organization Name:MARKS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NIEZGODA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, MSW
Authorized Official - Phone:206-321-3997
Mailing Address - Street 1:PO BOX 84097
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-8497
Mailing Address - Country:US
Mailing Address - Phone:206-321-3997
Mailing Address - Fax:
Practice Address - Street 1:4219 S OTHELLO ST APT 517
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3886
Practice Address - Country:US
Practice Address - Phone:206-321-3997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty