Individual
MICHAEL SCOTT MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
107 N 8TH ST, SHELTON, WA 98584-2513
(360) 426-9717
(360) 426-9750
Mailing address
PO BOX 11009, OLYMPIA, WA 98508-1009
(360) 352-2037
(360) 352-0637
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA10003073
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132055
L&I
WA
01
—
MY0098
REGENCE RIDER
WA
Enumeration date
10/04/2006
Last updated
08/07/2008
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