Individual
DR. MARK TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
(425) 339-5444
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 304-8431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD.MD.61144305
WA
207Q00000X
Family Medicine Physician
Primary
MD61144305
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2018
Last updated
04/27/2023
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