Individual
MERCEDES LONGTON CONVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
(503) 847-0141
Mailing address
1640B SLEATER KINNEY RD NE, OLYMPIA, WA 98506-3730
(503) 847-0141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
11/11/2019
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