MEDICARE: JOSHUA L MARK PHARM.D., R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH00052219	WA
2	1835X0200X	Oncology Pharmacist	17352	NV
3	183500000X	Pharmacist	RP00006827	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH00052219	OTHER	WA	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1467441097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA L MARK PHARM.D., R.PH.

Provider Business Mailing Address
First Line	:	7220 69TH AVE SE
Second Line	:
City	:	SNOHOMISH
State	:	WA
Zip	:	98290-6032
Country	:	US
Telephone Number	:	702-539-7920
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 MADISON ST STE 444
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-3588
Country	:	US
Telephone Number	:	206-386-6215
Fax Number	:	206-386-2134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	12/13/2023

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