Provider Demographics
NPI:1790785962
Name:HOITINK, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:HOITINK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8524 W GAGE BLVD
Mailing Address - Street 2:BLDG A-1 BOX 319
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8241
Mailing Address - Country:US
Mailing Address - Phone:509-591-0070
Mailing Address - Fax:509-396-9661
Practice Address - Street 1:7401 W HOOD PL STE 200
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3400
Practice Address - Country:US
Practice Address - Phone:509-591-0070
Practice Address - Fax:509-396-9661
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00031789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11147960OtherCAQH
WA1120724Medicaid
WA1120724Medicaid
BH 3460413OtherDEA
WA8807325Medicare PIN