Provider Demographics
NPI:1285832956
Name:EICHLER, MARK JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JACOB
Last Name:EICHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 NE 87TH AVE
Mailing Address - Street 2:BLDG B, SUITE 301
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1989
Mailing Address - Country:US
Mailing Address - Phone:360-514-7374
Mailing Address - Fax:360-514-7384
Practice Address - Street 1:505 NE 87TH AVE
Practice Address - Street 2:BLDG B, SUITE 301
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1989
Practice Address - Country:US
Practice Address - Phone:360-514-7374
Practice Address - Fax:360-514-7384
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD157519208600000X
WAMD60337677208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery