Provider Demographics
NPI:1144205204
Name:HOUK, MARK WILLIAM (DC, DABCO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:WILLIAM
Last Name:HOUK
Suffix:
Gender:M
Credentials:DC, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14011 N RIVERBLUFF LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9247
Mailing Address - Country:US
Mailing Address - Phone:509-466-1367
Mailing Address - Fax:509-465-4929
Practice Address - Street 1:9720 N NEVADA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3412
Practice Address - Country:US
Practice Address - Phone:509-464-2273
Practice Address - Fax:509-242-1954
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T02319Medicare UPIN
WAG319200001Medicare PIN