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Individual

MARK JAMES PADRNOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
Mailing address
PO BOX 2329, MOUNT VERNON, WA 98273-7329
(360) 336-6517
(360) 466-2682

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00107541
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004443
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0164787
DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
5032PA
REGENCE BLUE SHIELD
WA
05
9609280
WA
Enumeration date
02/22/2006
Last updated
07/11/2008
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