Provider Demographics
NPI:1154598019
Name:LOOD, MARY HO-MONG BACH (MD, PHARMD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:HO-MONG BACH
Last Name:LOOD
Suffix:
Gender:F
Credentials:MD, PHARMD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHARMD
Mailing Address - Street 1:1601 E 4TH PLAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3713
Mailing Address - Country:US
Mailing Address - Phone:208-422-1145
Mailing Address - Fax:208-422-1038
Practice Address - Street 1:1601 E 4TH PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3713
Practice Address - Country:US
Practice Address - Phone:208-422-1145
Practice Address - Fax:208-422-1038
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60151466207RR0500X, 207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine