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Individual
MARK R DUTTON
Active
Individual
MARK R DUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00007051
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146767
L&I
WA
01
—
193242800
OWCP
WA
05
—
8336422
—
WA
Enumeration date
08/09/2005
Last updated
03/03/2017
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