| Doctor Name: | MARK A MORTIER |
| NPI Number: | 1003979246 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | L0487 |
| Business Practice Address: | Commander Usa Meddac Ak Mcuc-mmd (attn Credentials) 1060 Gaffney Rd Ste 7440 Ft Wainwright, AK - 997037440 |
| Business Phone Number: | 9073535418 |
| Business Fax Number: | 9073534847 |
| Mailing Address: | Commander Usa Meddac Ak Mcuc-mmd (attn Credentials), 1060 Gaffney Rd Ste 7440 FT WAINWRIGHT |
| State: | AK |
| Postal Code: | 997037440 |
| Phone Number: | 9073535418 |
| Fax Number: | 9073534847 |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | L0487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |