Mark Daniel Bouchard, MD

Pediatrics Physician · Issaquah, WA

Individual Active NPI

NPI number 1316392517

Practice location

751 NE Blakely Dr Ste 5010
Issaquah, WA 98029-6201
Phone
(425) 394-0700
Fax
(425) 394-0757

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NPI record

NPI
1316392517
Entity type
Individual (Type 1)
Enumeration date
April 26, 2016
Last updated
January 17, 2022
Certified
January 17, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X MD61046264 WA

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone
(206) 320-4476
Fax
(206) 568-7043

About Dr. Bouchard

Mark Daniel Bouchard, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 751 NE Blakely Dr Ste 5010, Issaquah, WA 98029-6201. The NPI number 1316392517 was assigned on April 26, 2016 and the record was last updated on January 17, 2022.

Dr. Bouchard lists a license in the registry: #MD61046264 (WA) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Daniel Bouchard, MD?

The NPI number is 1316392517.

What is the phone number of Dr. Bouchard?

The phone number listed for the practice location is (425) 394-0700.

Where is Dr. Bouchard located?

751 NE Blakely Dr Ste 5010, Issaquah, WA 98029-6201.

What is the taxonomy code for Dr. Bouchard?

The primary taxonomy code is 208000000X – Pediatrics Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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