Individual
MARK A. FLORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
237 PROFESSIONAL WAY, SHELTON, WA 98584-4404
(360) 426-2500
Mailing address
237 PROFESSIONAL WAY, SHELTON, WA 98584-4404
(360) 426-2500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10005173
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8481137
—
WA
Enumeration date
05/03/2007
Last updated
01/23/2008
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