Basic Information
| Provider Information | |||||||||
| NPI: | 1932146552 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIENKO | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 850 | ||||||||
| Address2: | |||||||||
| City: | PORT ANGELES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983620146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606839895 | ||||||||
| FaxNumber: | 3605825614 | ||||||||
| Practice Location | |||||||||
| Address1: | 844 N 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | SEQUIM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983823045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606839895 | ||||||||
| FaxNumber: | 3605825614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 02/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | MD00046621 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | MD00046621 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.