Individual
MARK CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
(425) 339-5444
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00024510
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007669
—
WA
Enumeration date
03/09/2006
Last updated
09/14/2020
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