Individual
DR. MARK G EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
16818 E DESMET CT, SPOKANE VALLEY, WA 99216-3542
(509) 456-5380
(509) 456-5381
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003015
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043183
—
ID
05
—
1005298
—
WA
01
—
410022656
RAIL ROAD MEDICARE
WA
01
—
410045027
RAIL ROAD MEDICARE
WA
01
—
410045028
RAIL ROAD MEDICARE
ID
Enumeration date
07/07/2006
Last updated
11/19/2020
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