Individual
MARK JAMES LISOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 424-4111
Mailing address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 424-4111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD60920069
WA
207P00000X
Emergency Medicine Physician
R75483
AZ
Other
Enumeration date
04/12/2016
Last updated
08/06/2024
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