Individual
MARK ISADORE HAINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENUE, TACOMA, WA 98431-8561
(253) 968-6520
Mailing address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENUE, TACOMA, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
DOS-843
HI
207RC0000X
Cardiovascular Disease Physician
OP60194415
WA
207RI0011X
Interventional Cardiology Physician
Primary
OP60194415
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0940HA
REGENCE BLUESHIELD
—
05
—
1255314944
—
WA
Enumeration date
11/28/2005
Last updated
04/28/2019
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