Individual
DR. MARK LEWIS NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2245 S 19TH ST, 200, TACOMA, WA 98405-2945
(253) 572-1444
(253) 830-2528
Mailing address
2245 S 19TH ST, 200, TACOMA, WA 98405-2945
(253) 572-1444
(253) 830-2528
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00043072
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8895607
PTAN
WA
Enumeration date
02/08/2006
Last updated
04/10/2024
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