NPI Code Details Logo

NPI 1215148309

NPI 1215148309 : MECHELLE R FLEISCHER PA-C : BREMERTON, WA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1215148309
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MECHELLE R FLEISCHER PA-C
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/24/2007
-----------------------------------------------------
    Last Update Date     |    02/29/2008
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2771 HEMLOCK ST STE 100 
-----------------------------------------------------
    City                 |    BREMERTON
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98310-2689
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    360-473-0441
-----------------------------------------------------
    Fax                  |    360-377-1532
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2771 HEMLOCK ST STE 100 
-----------------------------------------------------
    City                 |    BREMERTON
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98310-2689
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    360-473-0441
-----------------------------------------------------
    Fax                  |    360-377-1532
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363A00000X
-----------------------------------------------------
    Taxonomy Name        |    Physician Assistant
-----------------------------------------------------
    License Number       |    PA10001395
-----------------------------------------------------
    License Number State |    WA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.