Individual
DR. MARK ATA MALAKOOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MTM&H
Contact information
Practice address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-4396
Mailing address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-4396
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
60664272
WA
2083P0901X
Public Health & General Preventive Medicine Physician
0101232164
VA
Other
Enumeration date
01/24/2006
Last updated
01/18/2024
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