Individual
MRS. MELINDA CECILE EKHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3994 COLVILLE RD, LOON LAKE, WA 99148-9789
(509) 233-8412
(509) 233-2864
Mailing address
3994 COLVILLE RD, PO BOX 303, LOON LAKE, WA 99148-9789
(509) 233-8412
(509) 233-2864
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30005591
WA
363LP2300X
Primary Care Nurse Practitioner
RN00082739
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143010
LABOR & INDUSTRIES ID #
WA
05
—
9629320
—
WA
Enumeration date
09/25/2006
Last updated
03/31/2008
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