Individual
DR. MEREDITH JILL DISTANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
415 NE BIRCH STREET, CAMAS, WA 98607
(360) 834-2732
(360) 834-3063
Mailing address
415 NE BIRCH STREET, CAMAS, WA 98607
(360) 834-2732
(360) 834-3063
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
1138
OR
175F00000X
Naturopath
Primary
NT00001485
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
229268
OMAP PROVIDER NUMBER
OR
Enumeration date
06/10/2006
Last updated
08/16/2012
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