Provider Demographics
NPI:1386648814
Name:HUNT, MARK E (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:HUNT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97115
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98497-0115
Mailing Address - Country:US
Mailing Address - Phone:253-588-7911
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST NE
Practice Address - Street 2:STE B
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4906
Practice Address - Country:US
Practice Address - Phone:253-288-2140
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00000905207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1112788Medicaid
WAGAB21355Medicare ID - Type Unspecified
B18208Medicare UPIN