Healthcare Provider Details

I. General information

NPI: 1891846077
Provider Name (Legal Business Name): MARK WALTER LAYTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 HARRISON AVE NW
OLYMPIA WA
98502-5466
US

IV. Provider business mailing address

1212 HARRISON AVE NW
OLYMPIA WA
98502-5466
US

V. Phone/Fax

Practice location:
  • Phone: 360-754-6700
  • Fax: 360-754-0164
Mailing address:
  • Phone: 360-754-6700
  • Fax: 360-357-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00024518
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMD00024518
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD00024518
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: