Individual
TAMARA ELLEN MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
817 COMMERCIAL ST, LEAVENWORTH, WA 98826-1316
(509) 548-5815
(509) 548-2510
Mailing address
817 COMMERCIAL ST, LEAVENWORTH, WA 98826-1316
(509) 548-3430
(509) 548-2510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP00002089
WA
208D00000X
General Practice Physician
Primary
OP00002089
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
316507
DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
—
452251
DEPARTMENT OF LABOR AND INDUSTRIES
WA
05
—
8464240
—
WA
Enumeration date
07/10/2006
Last updated
06/02/2023
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