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Individual

MRS. MELISSA MERCEDES CARDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1520 PLEASANT ST, WALLA WALLA, WA 99362-3738
(509) 979-0838
Mailing address
920 MOUNTAIN PARK DR, WALLA WALLA, WA 99362-1533
(509) 979-0838

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160235990
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P160235990
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
06/15/2022
Last updated
06/15/2022
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