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General NPI Number Information
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NPI Number | 1770603581
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Entity Type | Individual
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Provider Name | LINDA RAE MYHRES LMT
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 106 W LAURIDSEN BLVD
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City | PORT ANGELES
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State | WA
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Zip | 98362-7752
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Country | US
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Telephone | 425-931-8621
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Fax | 425-931-8621
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Provider Business Mailing Address
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Address Line | 161 FARRINGTON RD
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City | PORT ANGELES
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State | WA
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Zip | 98363-9716
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Country | US
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Telephone | 425-931-8621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00022663
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License Number State | WA
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