Doctor Name: | MR. MARK THOMAS QUINTANA |
NPI Number: | 1003031279 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP |
License Number: | MA00010444 |
Business Practice Address: | 10212 5th Ave Ne Suite #116 Seattle, WA - 981257452 |
Business Phone Number: | 2065254325 |
Business Fax Number: | 2065253775 |
Mailing Address: | 10212 5th Ave Ne, Suite #116 SEATTLE |
State: | WA |
Postal Code: | 981257452 |
Phone Number: | 2065254325 |
Fax Number: | 2065253775 |
NPI Enumeration Date: | 04/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00010444 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |