Individual
DR. MARK S PECKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3525 ENSIGN RD., SUITE A, OLYMPIA, WA 98505-0001
(360) 456-4666
(360) 459-1566
Mailing address
3525 ENSIGN RD NE, SUITE A, OLYMPIA, WA 98506-5065
(360) 456-4666
(360) 459-1566
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00019049
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17815
LABOR AND INDUSTRIES
WA
05
—
1789601
—
WA
01
—
G001048501
PTAN
WA
01
—
T00100
REGENCE
WA
Enumeration date
06/29/2006
Last updated
01/21/2015
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