Individual
JOEL A MECKSTROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
307 S. 13TH STREET, SUITE 300, MOUNT VERNON, WA 98274
(360) 336-9757
(360) 336-2088
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
AP30004883
WA
363L00000X
Nurse Practitioner
Primary
AP30004883
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263703
LABOR & INDUSTRIES
WA
05
—
9627555
—
WA
Enumeration date
06/24/2006
Last updated
02/20/2014
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