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General NPI Number Information
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NPI Number | 1881693919
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Entity Type | Individual
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Provider Name | MARK J ERWIN PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 5633 N LIDGERWOOD ST
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City | SPOKANE
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State | WA
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Zip | 99208-1224
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Country | US
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Telephone | 509-252-6336
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Fax | 509-252-6337
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Provider Business Mailing Address
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Address Line | 9631 N NEVADA ST STE 210
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City | SPOKANE
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State | WA
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Zip | 99218-1197
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Country | US
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Telephone | 509-319-2431
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Fax | 877-568-2402
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10004364
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License Number State | WA
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