Provider Demographics
NPI:1942271424
Name:SCOONES, MARK H (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:SCOONES
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-6110
Mailing Address - Country:US
Mailing Address - Phone:360-533-0633
Mailing Address - Fax:360-533-2541
Practice Address - Street 1:303 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-6110
Practice Address - Country:US
Practice Address - Phone:360-533-0633
Practice Address - Fax:360-533-2541
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA951231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA65266OtherWA DEPT OF L & I
WA911733515SC6476OtherREGENCE
MI96368/48014OtherHEARPO
WA2100250 1100565OtherCOMMUNITY HEALTH PLANWA
WA7078355Medicaid
WA9042599Medicaid
MI96368/48014OtherHEARPO