Individual
MRS. GWENDOLYN J MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
21 N VALLEY RD, NASELLE, WA 98638-8536
(360) 484-7161
(360) 484-7178
Mailing address
PO BOX H, ILWACO, WA 98624-0258
(360) 642-6350
(360) 642-6309
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30004334
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30004334
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176606
L & I
WA
01
—
6671WE
BCBS
WA
05
—
9631748
—
WA
Enumeration date
09/27/2005
Last updated
08/23/2019
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