Marion Fossum, MD in Medical Lake, WA - Student in an Organized Health Care Education/Training Program

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.

Contact Information

	Marion Fossum, MD
	1717 S Ritchey Rd, Medical Lake, WA 99022-8792
	(509) 590-8766
	Not Available

Physician's Profile

Full Name	Marion Fossum
Gender	Male
Speciality	Student In An Organized Health Care Education/training Program
Location	1717 S Ritchey Rd, Medical Lake, Washington
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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Marion Fossum, MD - Student in an Organized Health Care Education/Training Program in Medical Lake, WA