Mitchell T Marks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9119 Mil Park Ave
Joint Base Lewis McChord, WA 98433

Phone

(253) 477-0800

NPI assigned

Aug 28, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1326594680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 786",
            "address_2": "FORT RICHARDSON TMC",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99505",
            "telephone_number": "907-384-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 MIL PARK AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "253-477-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "MITCHELL",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2022-06-08",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Cooper Procter Maloney, DO
• Clayton Todd Manning, PHD
• Philippe Mansour, DMD
• Rowena V Marcelo, RN
• Kathleen Marinelli, DMD
• Devin Marsh, PH.D.
• Ian Christopher May, M.D.
• Katy L McCleery, D.O.
• Alina McGlothlin, RDH
• Daniel Paul McGuire, MD

• Physician Assistant in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.