Individual
DR. MARK D BALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2201 NW MARKET ST, SEATTLE, WA 98107-4025
(206) 789-7417
(206) 789-7651
Mailing address
2201 NW MARKET ST, SEATTLE, WA 98107-4025
(206) 789-7417
(206) 789-7651
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1411TX
WA
152WC0802X
Corneal and Contact Management Optometrist
1411TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410004828
RAILROAD MEDICARE
WA
Enumeration date
10/12/2006
Last updated
05/07/2014
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