Individual
MARK HITCHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
205 THREE RIVERS DR, KELSO, WA 98626-3127
(360) 578-7387
Mailing address
516 26TH AVE, LONGVIEW, WA 98632-1328
(503) 410-8369
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
60324633
WA
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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