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1427262245
MARK O FOSDAL
SEATTLE, WA
NPI
1427262245
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: WA PA10003666)
Enumeration Date
2007-05-10
Last Update Date
2007-07-09
Business Address
-- MARK O FOSDAL PA C
825 EASTLAKE AVE E
SEATTLE, WA 98109-4405
Phone number: 206-288-1000
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Mailing Address
-- MARK O FOSDAL PA C
PO BOX 50095
SEATTLE, WA 98145-5095
Phone number: 206-543-6420
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