Individual
DR. MARK G EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
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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