Individual
MARK DAVID HAFERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1135 116TH AVE NE, SUITE 160, BELLEVUE, WA 98004-4623
(425) 688-5289
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD00006018
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2743
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8265301
—
WA
Enumeration date
10/27/2006
Last updated
07/08/2007
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