| Doctor Name: | MR. MARK P. DARTLEY |
| NPI Number: | 1265414494 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA10003910 |
| Business Practice Address: | 850 Maple Street Medical Lake, WA - 990220800 |
| Business Phone Number: | 5095654000 |
| Business Fax Number: | 5095657015 |
| Mailing Address: | Po Box 800, 850 Maple Street MEDICAL LAKE |
| State: | WA |
| Postal Code: | 990220800 |
| Phone Number: | 5095654000 |
| Fax Number: | 5095657015 |
| NPI Enumeration Date: | 11/15/2005 |
| NPI Last Update Date: | 01/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA10003910 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |