Individual
MARK H BACKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1103 CLEVELAND AVE, MOUNT VERNON, WA 98273-4215
(360) 336-6868
(360) 336-6866
Mailing address
1103 CLEVELAND AVE, MOUNT VERNON, WA 98273-4215
(360) 336-6868
(360) 336-6866
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00015319
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031368
—
WA
Enumeration date
06/01/2006
Last updated
04/21/2010
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