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Mr. Mark Allen Hathaway
Private Vehicle in Portland, Oregon
NPI 1942517131

Mark Allen Hathaway is a Private Vehicle based in Portland, OR. Mark Allen Hathaway practices in Portland, OR. The NPI Number for Mark Allen Hathaway is 1942517131 and holds a License No. 3831943 (Oregon).

The current practice location address for Mark Allen Hathaway is 833 Sw 11Th Ave, Portland, OR and can be reached out via phone at 503-228-1510.

Location: 833 Sw 11Th Ave, Portland, OR, 97205-2125
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942517131
Provider Name
Mark Allen Hathaway
Credential
Provider Entity Type
Individual
Gender
Male
Address
833 Sw 11Th Ave, Portland, OR, 97205-2125
Phone Number
503-228-1510
Fax Number
Provider Enumeration Date
09/09/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
833 Sw 11Th Ave
City
Portland
State
Oregon
Zip
97205-2125
Phone Number
503-228-1510
Fax Number
person
Provider Business Mailing Address Details
Address
833 Sw 11Th Ave
City
Portland
State
Oregon
Zip
97205-2125
Phone Number
503-228-1510
Fax Number
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
3831943 (Oregon)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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