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Individual

MR. MARK ALLAN GREENWALT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9505 S STEELE ST, TACOMA, WA 98444-1858
(253) 597-6800
Mailing address
9505 S STEELE ST, TACOMA, WA 98444-1858
(253) 597-6800

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61611340
WA

Other

Enumeration date
10/18/2024
Last updated
11/20/2024
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