Individual
MARK A. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E. KINCADE STREET, MOUNT VERNON, WA 98274-4127
(360) 428-6434
(360) 848-4233
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00024510
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030741
—
WA
Enumeration date
01/08/2007
Last updated
06/04/2015
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