Individual
MS. MELISSA ROSE BERNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
77 SW RUSSELL AVE, STEVENSON, WA 98648-9198
(360) 521-1523
Mailing address
PO BOX 302, 33 EAST CASCADE DRIVE, NORTH BONNEVILLE, WA 98639-0302
(360) 521-1523
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00020546
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00020546
CREDENTIALS FOR STATE OF WASHINGTON
WA
Enumeration date
03/16/2017
Last updated
03/16/2017
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