Individual
MR. MARK ANTHONY FORTES BAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDRT(WA-CERT)
Contact information
Practice address
1519 3RD ST SE STE 102, PUYALLUP, WA 98372-3742
(253) 841-0705
Mailing address
16302 66TH AVE E, PUYALLUP, WA 98375-9025
(253) 355-9486
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
RT61618487
WA
Other
Enumeration date
02/22/2025
Last updated
02/22/2025
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