Individual
MELISSA WALIEZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
117 WILSON RD, WINLOCK, WA 98596-9632
(716) 545-9828
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60260858
WA
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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