Provider Demographics
NPI:1497086847
Name:DUVALL, MARK L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:DUVALL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S PIONEER WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-4637
Mailing Address - Country:US
Mailing Address - Phone:509-765-8891
Mailing Address - Fax:509-765-4280
Practice Address - Street 1:1550 S PIONEER WAY STE 105
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-4637
Practice Address - Country:US
Practice Address - Phone:509-765-8891
Practice Address - Fax:509-765-4280
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60024043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist