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Individual

MERRILY MOUNT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.R.N.P.

Contact information

Practice address
294843 HWY 101, QUILCENE, WA 98376
(360) 765-3111
(360) 765-3811
Mailing address
294843 HWY 101, QUILCENE, WA 98376
(360) 765-3111
(360) 765-3811

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30000284
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9615204
WA
Enumeration date
06/08/2006
Last updated
08/30/2011
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