Bouchard, Mark Daniel
Bouchard, Mark Daniel is an individual health care provider with primary practice located at 751 Ne Blakely Dr Ste 5010 , Issaquah WA 98029-6201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bouchard, Mark Daniel can be contacted via phone (425) 394-0700.Contact Information
Primary practice address
751 Ne Blakely Dr Ste 5010
Issaquah WA 98029-6201
Phone: (425) 394-0700
Fax: (425) 394-0757
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD61046264 | Washington |
Profile Details
| NPI number | 1316392517 |
|---|---|
| LBN Legal business name | Bouchard, Mark Daniel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2016 |
| Last updated | Jan 17th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316392517 | NPPES |
| Washington | MEDICAID | 1316392517 |
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