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Individual

MARK A SEABURG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2823 GRIFFIN AVE, ENUMCLAW, WA 98022-2322
(360) 825-1614
(360) 825-8034
Mailing address
2823 GRIFFIN AVE, ENUMCLAW, WA 98022-2322
(360) 825-1614
(360) 825-8034

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001260
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2033207
WA
Enumeration date
08/24/2006
Last updated
06/20/2011
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