Peckler, Mark S
Peckler, Mark S is an individual health care provider with primary practice located at 3525 Ensign Rd. Suite A, Olympia WA 98505-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Peckler, Mark S can be contacted via phone (360) 456-4666.Contact Information
Primary practice address
3525 Ensign Rd. Suite A
Olympia WA 98505-0001
Phone: (360) 456-4666
Fax: (360) 459-1566
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Urology | 208800000X | MD00019049 | Washington |
Profile Details
NPI number | 1770511438 |
---|---|
LBN Legal business name | Peckler, Mark S |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 29th, 2006 |
Last updated | Jan 21st, 2015 - about 9 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 | 1770511438 | NPPES |
Washington | Other | 17815 | LABOR AND INDUSTRIES |
Washington | MEDICAID | 1789601 | LABOR AND INDUSTRIES |
Washington | Other | T00100 | LABOR AND INDUSTRIES |
Washington | Other | G001048501 | LABOR AND INDUSTRIES |
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