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DR. THEODORE DUNGAN MANDELKORN MD NPI 1922167220


NPI Information

NPI: 1922167220
Provider Name: DR. THEODORE DUNGAN MANDELKORN, MD
Classification: Pediatrics - 2080P0006X
Entity Type: Individual

Specialization: Developmental - Behavioral Pediatrics

PECOS Registration: Yes

Address:
2553 76TH AVE SE
MERCER ISLAND, WA
ZIP 98040
Phone: (206) 275-0702
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DR. Theodore Dungan Mandelkorn, MD is a developmental - behavioral pediatrics pediatrics in Mercer Island, WA. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. DR. Theodore Dungan Mandelkorn, MD NPI is 1922167220. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2553 76TH AVE SE
MERCER ISLAND, WA
ZIP 98040-758
Phone: (206) 275-0702

The NPI 1922167220 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0006XPediatricsDevelopmental - Behavioral PediatricsMD00010762WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.