Individual
MR. MARK CHESLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPD
Contact information
Practice address
4367 RUCKER AVE, EVERETT, WA 98203-2213
(425) 259-2800
(425) 259-2800
Mailing address
8405 15TH PL NE, EVERETT, WA 98205-1485
(425) 377-1664
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN 00000342
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5043450
DSHS PROVIDER NUMBER
WA
Enumeration date
09/25/2006
Last updated
07/08/2007
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