Peckler, Mark S

Peckler, Mark S is an individual health care provider with primary practice located at 3525 Ensign Rd. Suite A, Olympia WA 98505-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Peckler, Mark S can be contacted via phone (360) 456-4666.

Contact Information

Primary practice address
3525 Ensign Rd. Suite A Olympia WA 98505-0001
Phone: (360) 456-4666
Fax: (360) 459-1566
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD00019049 Washington

Profile Details

NPI number 1770511438
LBN Legal business name Peckler, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jan 21st, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770511438 NPPES
Washington Other 17815 LABOR AND INDUSTRIES
Washington MEDICAID 1789601 LABOR AND INDUSTRIES
Washington Other T00100 LABOR AND INDUSTRIES
Washington Other G001048501 LABOR AND INDUSTRIES

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