Individual
MELVIN CLYDE MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO/ABOM
Contact information
Practice address
1230 SEVENTH AVE., LONGVIEW, WA 98632
(360) 636-6238
Mailing address
PO BOX 1005, CASTLE ROCK, WA 98611-1005
(360) 274-5889
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO00000643
WA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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