Hattenhauer, Mark Thomas

Hattenhauer, Mark Thomas is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2367. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Hattenhauer, Mark Thomas can be contacted via phone (360) 414-2730.

Contact Information

Primary practice address
1615 Delaware St Longview WA 98632-2367
Phone: (360) 414-2730
Fax: (360) 414-2739
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD07556 Oregon
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD00028883 Washington

Profile Details

NPI number 1295740702
LBN Legal business name Hattenhauer, Mark Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Apr 8th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295740702 NPPES
Washington MEDICAID 8563314
Washington MEDICAID 085084

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