Provider Demographics
NPI:1629425566
Name:BARBIN, MARK ANTHONY FRANCIS (PA)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANTHONY FRANCIS
Last Name:BARBIN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3329
Mailing Address - Country:US
Mailing Address - Phone:937-308-2701
Mailing Address - Fax:
Practice Address - Street 1:702 E MOUNTAIN VIEW AVE STE 1
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3862
Practice Address - Country:US
Practice Address - Phone:509-968-5273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program