Individual
MARK WILSON TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 KNECHTEL WAY NE STE 111, BAINBRIDGE ISLAND, WA 98110-2834
(206) 472-0535
Mailing address
345 KNECHTEL WAY NE STE 111, BAINBRIDGE ISLAND, WA 98110-2834
(206) 472-0535
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
603312792
WA
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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