Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1316392517 Individual Practitioner Male Practitioner

Dr. Mark Daniel Bouchard , MD

Pediatrics • Issaquah, WA

Professional Overview & Biography Verified Profile Summary

Dr. Mark Bouchard, MD is a registered healthcare professional specializing in Pediatrics in Issaquah, WA. Practice services are available at 751 NE BLAKELY DR STE 5010 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

751 Ne Blakely Dr Ste 5010

Issaquah, WA 980296201

Telephone 4253940700
Fax 4253940757
Associated Practice Facility / Clinic
🏢 Swedish Health Services Facility NPI 1174563050

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Issaquah, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 18.8 Yrs
Regional Practice Density
22 Specialists

Practicing in Issaquah, WA (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-01-17
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA MD61046264

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1316392517 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

22 Associated Practitioners
Dr. Haejun Ahn , MD

Pediatrics - Pediatric Nephrology

NPI 1013379221

Doctor of Medicine (M.D.)

Miranda Canfield , RD

Dietitian, Registered

NPI 1093336596

Registered Dietitian

NPI 1134385164

Doctor of Medicine (M.D.)

Dr. Helen Hansen , PsyD

Psychologist - Clinical

NPI 1174801674

Doctor of Psychology (Psy.D.)

Dr. Eric Schultz , DO

Internal Medicine

NPI 1255891396

Doctor of Osteopathic Medicine (D.O.)

Darcy Wyatt , LICSW

Social Worker - Clinical

NPI 1336539071

Licensed Independent Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
📍
Updated Practice Location January 17, 2022

Registered at 751 NE BLAKELY DR STE 5010, ISSAQUAH, WA 980296201 (Tel: 4253940700)

📍
Updated Business Mailing Address January 17, 2022

Registered at PO BOX 25608, SALT LAKE CITY, UT 841250608 (Tel: 2063204476)

👤
Provider Name / Credentials Updated January 17, 2022

Recorded as MARK BOUCHARD, MD

📍
Updated Practice Location May 18, 2021

Registered at 201 16TH AVE E, SEATTLE, WA 981125226 (Tel: 2063263000)

📍
Updated Business Mailing Address May 18, 2021

Registered at 201 16TH AVE E, SEATTLE, WA 981125226 (Tel: 2063263000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2021

Pediatrics (License #MD61046264 in WA)

📍
Updated Practice Location December 28, 2020

Registered at 9800 4TH AVE NE, SEATTLE, WA 981152152 (Tel: 2063021200)

📍
Updated Business Mailing Address December 28, 2020

Registered at 9800 4TH AVE NE, SEATTLE, WA 981152152 (Tel: 2063021200)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2019

Pediatrics (License #300476 in NY)

NPI Profile Active April 26, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location April 26, 2016

Registered at 475 SEAVIEW AVE, STATEN ISLAND, NY 103053436 (Tel: 7182269000)

📍
Updated Business Mailing Address April 26, 2016

Registered at PO BOX 1303, PEMBROKE, MA 023591303

👤
Provider Name / Credentials Updated April 26, 2016

Recorded as MARK BOUCHARD, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 26, 2016

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 26, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316392517
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 26, 2016
Last Update: January 17, 2022
Sole Proprietor: No

Mailing Address

Po Box 25608

Salt Lake City, UT 841250608

Phone: 2063204476

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.