Provider Demographics
NPI:1235950973
Name:MARZOUK, OSAMA (MD)
Entity type:Individual
Prefix:DR
First Name:OSAMA
Middle Name:
Last Name:MARZOUK
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 1:4828 W GLENHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-1733
Mailing Address - Country:US
Mailing Address - Phone:206-300-3010
Mailing Address - Fax:
Practice Address - Street 1:4828 W GLENHAVEN DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-1733
Practice Address - Country:US
Practice Address - Phone:206-300-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental Hygienist
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty