Provider Demographics
NPI:1366903171
Name:MARKEY-CRIMP, MATTHEW ARVID CULLENBERG (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ARVID CULLENBERG
Last Name:MARKEY-CRIMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 16TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5636
Mailing Address - Country:US
Mailing Address - Phone:206-324-8484
Mailing Address - Fax:206-320-8173
Practice Address - Street 1:550 16TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5636
Practice Address - Country:US
Practice Address - Phone:206-324-8484
Practice Address - Fax:206-320-8173
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD61156187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program