Organization
MDA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLON B MICHEL MD MBA (PRESIDENT)
(801) 369-3535
Entity
Organization
Contact information
Practice address
2711 200TH AVE E, LAKE TAPPS, WA 98391-9094
(801) 369-3535
Mailing address
2711 200TH AVE E, LAKE TAPPS, WA 98391-9094
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/29/2010
Last updated
08/13/2014
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