Provider Demographics
NPI:1841275369
Name:HAMILTON, MARK J (OD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:701 N 182ND ST
Mailing Address - Street 2:STE 101
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4430
Mailing Address - Country:US
Mailing Address - Phone:260-682-2020
Mailing Address - Fax:206-332-0700
Practice Address - Street 1:999 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-4019
Practice Address - Country:US
Practice Address - Phone:260-682-2020
Practice Address - Fax:206-332-0700
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA3374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist