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Individual

MR. MARK DETWILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
10811 12TH AVE SW, SEATTLE, WA 98146-2125
(206) 631-4516
(206) 631-4506
Mailing address
3441 WALNUT AVE SW, SEATTLE, WA 98116-3442
(206) 631-7323
(206) 631-7337

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN60346597
WA

Other

Enumeration date
12/15/2015
Last updated
12/15/2015
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