Individual
MELINDA RICKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSE PHLEBOTOMIST
Contact information
Practice address
750 WALKER RD, LEBANON, OR 97355-1154
(760) 468-6491
(760) 433-8469
Mailing address
750 WALKER RD, LEBANON, OR 97355-1154
(760) 468-6491
(760) 433-8469
Taxonomy
Speciality
Code
Description
License number
State
246QB0000X
Blood Banking Specialist/Technologist
—
—
246QM0706X
Medical Technologist
—
—
246QM0900X
Microbiology Specialist/Technologist
—
—
246RP1900X
Phlebotomy Technician
Primary
CPA-00003683
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
588868430
PASSPORT
CA
01
—
588868439
PASSPORT
CA
01
—
C805650
DRIVER'S LICENSE
OR
Enumeration date
05/06/2024
Last updated
05/06/2024
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