Provider Demographics
NPI:1780729400
Name:MCVEE, MARK OWEN (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:OWEN
Last Name:MCVEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S. STEVENS STREET
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-0000
Mailing Address - Country:US
Mailing Address - Phone:509-363-7788
Mailing Address - Fax:509-363-7064
Practice Address - Street 1:2751 DEBARR RD
Practice Address - Street 2:SUITE 390
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2952
Practice Address - Country:US
Practice Address - Phone:907-792-7920
Practice Address - Fax:907-792-7901
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD6000209682085R0202X
ORMD294322085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2005504Medicaid
ORR149589Medicare PIN
AKF96010Medicare UPIN
WA2005504Medicaid
AKMD6706Medicaid