Provider Demographics
NPI:1487966131
Name:DOYLE, MARK (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:DOYLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10635 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4372
Mailing Address - Country:US
Mailing Address - Phone:425-455-1881
Mailing Address - Fax:
Practice Address - Street 1:10620 NE 8TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4380
Practice Address - Country:US
Practice Address - Phone:425-455-1881
Practice Address - Fax:425-455-1882
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor