Mark Thomas Hattenhauer, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD07556 Issued in OR

Practice address

1615 Delaware St
Longview, WA 98632-2367

Phone

(360) 414-2730

Fax

(360) 414-2739

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthmark Inc

  • Diagnostic Radiology Physician
  • Portland, OR
  • NPI 1013075670
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1295740702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3002",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986320302",
            "telephone_number": "360-414-2730",
            "fax_number": "360-414-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322367",
            "telephone_number": "360-414-2730",
            "fax_number": "360-414-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTENHAUER",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD07556",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00028883",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8563314",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085084",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia E Harrison, LICSWA
• Amanda Renee Hart, CC, LMT
• Nicole Elaine Harvill, RN
• Laura Mae Hathaway
• Susan E Hather, CDPT
• Haven Mind Body Collective, LLC
• Ashley N Hawkes, ARNP
• David Norman Hawkins, CDP
• Diane C Hawkins, ARNP
• Wendi C Hawley, MA, ART-BC

• Cardiovascular Disease Physician in Longview, WA
• Providers in Longview, WA by specialty
• Cardiovascular Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.