Individual
IDALIS RAE CALVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
243511 W HIGHWAY 101, PORT ANGELES, WA 98363-9472
(360) 565-7264
(360) 452-6274
Mailing address
243511 W HIGHWAY 101, PORT ANGELES, WA 98363-9472
(360) 565-7264
(360) 452-6274
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
CG60769343
WA
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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