NPI 1942517131

Mark Allen Hathaway

Practitioner Private Vehicle Portland, OR

Practice location

Address: 833 SW 11th Ave Suite 428, Portland, OR 97205-2125
Phone: (503) 228-1510

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence 3831943 (OR)

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Registry record

NPI: 1942517131
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Sep 2010
Record last updated: 9 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.