Individual
MARK J. DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1151 ELLIS ST STE 202, BELLINGHAM, WA 98225-5245
(360) 746-2380
(360) 746-2382
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00020973
WA
207ND0101X
MOHS-Micrographic Surgery Physician
MD00020973
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230370
L&I/CRIME VICTIMS
WA
05
—
8180382
—
WA
Enumeration date
06/21/2005
Last updated
10/17/2024
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