Individual
MARK A MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4403 W COURT ST, SUITE J, PASCO, WA 99301-2879
(509) 547-9695
(509) 547-5017
Mailing address
4403 W COURT ST, SUITE J, PASCO, WA 99301-2879
(509) 547-9695
(509) 547-5017
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1383-TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2079507
—
WA
Enumeration date
01/25/2006
Last updated
11/29/2007
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