Individual
DR. EZEKIEL DEREK ALEXANDER MELQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N 13TH ST, SHELTON, WA 98584-2077
(360) 426-2653
(888) 985-0681
Mailing address
2411 CRESTRIDGE DR NW, OLYMPIA, WA 98502-9706
(347) 677-4264
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD61191074
WA
Other
Enumeration date
03/18/2013
Last updated
01/06/2025
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