Individual
MARK J LONERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001657
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2015352
—
WA
Enumeration date
02/08/2007
Last updated
09/27/2009
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