Individual
MARK S VOLLRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1500 CONTINENTAL PL, MOUNT VERNON, WA 98273-4105
(360) 424-7041
(360) 424-8449
Mailing address
1500 CONTINENTAL PL, MOUNT VERNON, WA 98273-4105
(360) 424-7041
(360) 424-8449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100000862
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127494
LABOR AND INDUSTRIES
WA
Enumeration date
07/19/2005
Last updated
03/31/2011
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