Individual
J SEMMES MICKELWAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1420 ROOSEVELT AVE, SUITE 7, MOUNT VERNON, WA 98273-2687
(360) 424-4186
(360) 428-0927
Mailing address
1420 ROOSEVELT AVE, SUITE 7, MOUNT VERNON, WA 98273-2687
(360) 424-4186
(360) 428-0927
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00013676
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124502
—
WA
Enumeration date
05/28/2006
Last updated
07/08/2007
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