Healthcare Provider Details

I. General information

NPI: 1174549505
Provider Name (Legal Business Name): LAURIE JEAN MERCIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 W CLEARWATER AVE STE G
KENNEWICK WA
99336-2765
US

IV. Provider business mailing address

306 N BARKER ROAD PO BOX 58
SPOKANE VALLEY WA
99016
US

V. Phone/Fax

Practice location:
  • Phone: 425-754-9015
  • Fax: 208-597-7033
Mailing address:
  • Phone: 425-754-9015
  • Fax: 206-428-7116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMD00037532
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: