Individual
MARK F BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7210 40TH ST W, STE 100, UNIVERSITY PLACE, WA 98466-4318
(253) 564-0170
Mailing address
7210 40TH ST W, STE 100, UNIVERSITY PLACE, WA 98466-4318
(253) 564-0170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00031603
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126533
STATE L&I
WA
01
—
0163664
STATE L&I
WA
01
—
80138476
MEDICARE RAILROAD
WA
05
—
8154320
—
WA
01
—
8928712
STATE CRIME VICTIMS
WA
01
—
8937675
STATE CRIME VICTIMS
WA
Enumeration date
07/07/2006
Last updated
11/16/2010
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