Individual
MEL PIERDOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
DO
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 397-4040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP61436516
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
05/24/2024
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