Individual
STEVEN L MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2500 RACQUET LN, STE 100, YAKIMA, WA 98902-6114
(509) 249-3900
(509) 573-9539
Mailing address
2500 RACQUET LN, STE 100, YAKIMA, WA 98902-6114
(509) 249-3900
(509) 573-9539
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
025211PA10003745
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8357519
—
WA
01
—
970029734
RAILROAD MEDICARE PIN
WA
Enumeration date
09/29/2005
Last updated
06/02/2016
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