Individual
JOHN MARK BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
304 W BAY DR NW, SUITE 301, OLYMPIA, WA 98502-4958
(360) 413-8760
(360) 413-8839
Mailing address
304 W BAY DR NW, SUITE 301, OLYMPIA, WA 98502-4958
(360) 413-8760
(360) 413-8839
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00017301
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8214603
—
WA
01
—
GAB20353
MEDICARE
WA
Enumeration date
07/28/2005
Last updated
10/22/2013
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