Provider Demographics
NPI:1295789139
Name:ESCANDON, MARK PHILLIP (AT,C)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:PHILLIP
Last Name:ESCANDON
Suffix:
Gender:M
Credentials:AT,C
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Other - Credentials:
Mailing Address - Street 1:22339 123RD PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-9653
Mailing Address - Country:US
Mailing Address - Phone:253-631-8902
Mailing Address - Fax:
Practice Address - Street 1:901 12TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4411
Practice Address - Country:US
Practice Address - Phone:206-296-5432
Practice Address - Fax:206-296-2154
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer