Healthcare Provider Details

I. General information

NPI: 1467441097
Provider Name (Legal Business Name): JOSHUA L MARK PHARM.D., R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MADISON ST STE 444
SEATTLE WA
98104-3588
US

IV. Provider business mailing address

7220 69TH AVE SE
SNOHOMISH WA
98290-6032
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-6215
  • Fax: 206-386-2134
Mailing address:
  • Phone: 702-539-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00052219
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number17352
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00006827
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: