Individual
TERRY J MENGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12040 NE 128TH ST, KIRKLAND, WA 98034-3013
(425) 899-1000
Mailing address
13223 NE 131ST PL, KIRKLAND, WA 98034-3346
(425) 941-5723
(425) 821-8613
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00023320
WA
207R00000X
Internal Medicine Physician
MD00023320
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032986
—
WA
01
—
6434
INTERNAL ID-MOTOR VEHICLE ID
—
01
—
U32651
REGENCE BLUESHIELD
WA
Enumeration date
10/27/2006
Last updated
04/29/2009
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