Provider Demographics
NPI:1598546095
Name:MCFEELEY, MARK H (RN)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:H
Last Name:MCFEELEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S 86TH PL
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1441
Mailing Address - Country:US
Mailing Address - Phone:509-961-4754
Mailing Address - Fax:
Practice Address - Street 1:210 S 86TH PL
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-1441
Practice Address - Country:US
Practice Address - Phone:509-961-4754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN130219163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse