Active NPI
Mark L Bowers, P.A.
- Surgical Physician Assistant
- Renton, WA
National Provider Identifier
1811040504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA10001195
- Practice address
- 4011 Talbot Rd S
Suite 300
Renton, WA 98055-5773 - Phone
- (425) 656-5060
- Fax
- (425) 656-5047
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA10001195 | WA | Primary |
Addresses
Primary practice location
4011 Talbot Rd S
Suite 300
Renton, WA 98055-5773
Mailing address
720 Olive Way
Suite 1505
Seattle, WA 98101-1878
Phone (206) 838-2590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811040504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 OLIVE WAY",
"address_2": "SUITE 1505",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011878",
"telephone_number": "206-838-2590",
"fax_number": "206-264-8689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4011 TALBOT RD S",
"address_2": "SUITE 300",
"city": "RENTON",
"state": "WA",
"postal_code": "980555773",
"telephone_number": "425-656-5060",
"fax_number": "425-656-5047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWERS",
"first_name": "MARK",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WA",
"license": "PA10001195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.