Individual
JOHN MARK BEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4410 106TH ST SW, MUKILTEO, WA 98275-4700
(425) 493-6000
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 493-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00025677
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
MD00025677
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230703
L&I
WA
05
—
1005385
—
WA
05
—
1225118201
—
WA
01
—
2005974
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/16/2006
Last updated
03/15/2017
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