Healthcare Provider Details

I. General information

NPI: 1790759363
Provider Name (Legal Business Name): MARK LYNN HOHSTADT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER 9040A REID STREET
TACOMA WA
98431-0001
US

IV. Provider business mailing address

6213 254TH ST E
GRAHAM WA
98338-9566
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-3234
  • Fax:
Mailing address:
  • Phone: 253-875-1754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number37952
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11946
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: