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General NPI Number Information
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NPI Number | 1447459136
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Entity Type | Organization
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Legal Business Name | MARK A. TOMSKI, MD
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 1626 BROOKMONTE DR SE
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City | PUYALLUP
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State | WA
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Zip | 98372-5189
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Country | US
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Telephone | 253-905-3367
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 BROOKMONTE DR SE
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City | PUYALLUP
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State | WA
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Zip | 98372-5189
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLO PRACTITIONER
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Name | MARK ANDREW TOMSKI
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Credential | M.D.
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Telephone | 253-905-3367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 26256
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License Number State | WA
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