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General NPI Number Information
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NPI Number | 1831228378
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Entity Type | Individual
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Provider Name | MERISSA PATRICE MAYERS MEDICAL ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2156 PACIFIC AVE
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City | TACOMA
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State | WA
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Zip | 98402-3004
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Country | US
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Telephone | 253-207-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 8763 A SAINT PAUL AVE
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City | FORT LEWIS
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State | WA
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Zip | 98433
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Country | US
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Telephone | 253-964-2902
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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 | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 432869
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License Number State | WA
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