Individual
MARK ALLAN WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE ANESTHETIST
Contact information
Practice address
3209 S 23RD ST, STE 340, TACOMA, WA 98405-1602
(253) 272-5127
Mailing address
2420 S UNION AVE STE 200, TACOMA, WA 98405-1323
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007011
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8909274
MDCR PTAN (K)
WA
01
—
G8911734
MDCR PTAN (P)
WA
Enumeration date
10/18/2006
Last updated
05/02/2019
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