Michael, Mark A
Michael, Mark A is an individual health care provider with primary practice located at 4403 W Court St Suite J, Pasco WA 99301-2879. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Michael, Mark A can be contacted via phone (509) 547-9695.Contact Information
Primary practice address
4403 W Court St Suite J
Pasco WA 99301-2879
Phone: (509) 547-9695
Fax: (509) 547-5017
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1383-TX | Washington |
Profile Details
| NPI number | 1457321069 |
|---|---|
| LBN Legal business name | Michael, Mark A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Nov 29th, 2007 - about 19 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 | 1457321069 | NPPES |
| Washington | MEDICAID | 2079507 |
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