Everett, Mark G
Everett, Mark G is an individual health care provider with primary practice located at 16818 E Desmet Ct , Spokane Valley WA 99216-3542. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Everett, Mark G can be contacted via phone (509) 456-5380.Contact Information
Primary practice address
16818 E Desmet Ct
Spokane Valley WA 99216-3542
Phone: (509) 456-5380
Fax: (509) 456-5381
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00003015 | Washington |
Profile Details
| NPI number | 1225060296 |
|---|---|
| LBN Legal business name | Everett, Mark G |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Nov 19th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225060296 | NPPES |
| Washington | MEDICAID | 1005298 | |
| Washington | MEDICAID | 0043183 | |
| Washington | Other | 410022656 | |
| Washington | Other | 410045028 | |
| Washington | Other | 410045027 |
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