Individual provider · NPI-1

Mark P. Dartley, PA-C

Physician Assistant, Medical · Medical Lake, WA

NPI number1265414494
StatusActive
Last updated in NPPESJan 27, 2015

Details

NPI
1265414494
Entity type
Individual (NPI-1)
Name
Mr. Mark P. Dartley
Credential
PA-C
Sex
Male
Sole proprietor
No
Enumeration date
Nov 15, 2005
Last updated
Jan 27, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, MedicalPA10003910WAYes

Practice location

850 Maple Street
Medical Lake, WA 99022-0800

Phone 509-565-4000 · Fax 509-565-7015

Mailing address

Po Box 800
850 Maple Street
Medical Lake, WA 99022-0800

Phone 509-565-4000 · Fax 509-565-7015

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