Marion Fossum, MD is a
Student In An Organized Health Care Education/training Program physician based in Medical Lake, Washington. Marion Fossum is licensed to practice in * (Not Available) (license number ) and his current practice location is 1717 S Ritchey Rd, Medical Lake, Washington. He can be reached at his office (for appointments etc.) via phone at
(509) 590-8766.
NPI number for Marion Fossum is 1356875736 and his current mailing address is 1717 S Ritchey Rd, Medical Lake, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356875736.
Physician's Profile
Full Name | Marion Fossum |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1717 S Ritchey Rd, Medical Lake, Washington |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1356875736
- Provider Enumeration Date: 04/12/2017
- Last Update Date: 11/25/2022
Medical Identifiers
Medical identifiers for Marion Fossum such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1356875736 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084E0001X | Psychiatry & Neurology - Epilepsy | 61254901 (Washington) | Secondary |
2084N0400X | Psychiatry & Neurology - Neurology | 61254901 (Washington) | Secondary |
2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 61254901 (Washington) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marion Fossum is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Marion Fossum, MD 1717 S Ritchey Rd, Medical Lake, WA 99022-8792 Ph: (509) 590-8766 | Marion Fossum, MD 1717 S Ritchey Rd, Medical Lake, WA 99022-8792 Ph: (509) 590-8766 |
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