Provider Demographics
NPI:1316056047
Name:PIERCE, MARK JAMES (MS, ATC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:JAMES
Last Name:PIERCE
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:JAMES
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC
Mailing Address - Street 1:7729 139TH PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4003
Mailing Address - Country:US
Mailing Address - Phone:425-941-0990
Mailing Address - Fax:
Practice Address - Street 1:506 2ND AVE
Practice Address - Street 2:100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2343
Practice Address - Country:US
Practice Address - Phone:206-264-9780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer