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Individual

AUDRA L MEADOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
4744 41ST AVE SW, 102, SEATTLE, WA 98116-4570
(206) 248-0150
(206) 248-9306
Mailing address
4744 41ST AVE SW, 102, SEATTLE, WA 98116-4570
(206) 248-0150
(206) 248-9306

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6019960260010001
UBI NUMBER
WA
01
MAOOOO9805
LMP
WA
Enumeration date
05/14/2007
Last updated
07/08/2007
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