MEDICARE: BELINDA JOY MYERS LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	60211165	WA

General Provider Information

NPI Number	:	1194015479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELINDA JOY MYERS LMP

Provider Business Mailing Address
First Line	:	6722 W KENNEWICK AVE
Second Line	:	SUITE B
City	:	KENNEWICK
State	:	WA
Zip	:	99336-1793
Country	:	US
Telephone Number	:	509-366-8366
Fax Number	:	866-300-0363

Provider Business Practice Location Address
First Line	:	6722 W KENNEWICK AVE
Second Line	:	SUITE B
City	:	KENNEWICK
State	:	WA
Zip	:	99336-1793
Country	:	US
Telephone Number	:	509-366-8366
Fax Number	:	866-300-0363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	11/10/2011

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