Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mark Tom

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1144712639

Dr. Mark Tom is a Family Practice in Everett, Washington. Graduated from University of Washington School of Medicine in 2018, 8 years ago. Practices with Providence Health and Services- Washington, a 526-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
8
Trained at
University of Washington School of Medicine
Licensed in
WA
In the registry since
2018
Specialties on file
3
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Practice location Address checks out

3927 Rucker Ave
Everett, WA 98201-4833
Phone: (425) 339-5422
Fax: (425) 339-5444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1919 Lincoln Way Ste 315, Coeur D Alene, ID 83814-2527 — (208) 625-6000
  • 14402 E Sprague Ave, Spokane Valley, WA 99216-2167 — (509) 922-2625

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD61144305 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Family Medicine Physician Taxonomy 207Q00000X · Licence MD.MD.61144305 (WA)

Record details

NPI number1144712639
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 31, 2018
Last updated in NPPESApril 27, 2023
Certification dateApril 27, 2023
Mailing addressPo Box 5127, Everett, WA 98206-5127

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Providence Health And Services- Washington — 526 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Everett