Provider Demographics
NPI:1295600401
Name:METOYER, MICKI A (CPM, LDEM)
Entity type:Individual
Prefix:
First Name:MICKI
Middle Name:A
Last Name:METOYER
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 PARK LN
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97138-4300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1319 PARK LN
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:OR
Practice Address - Zip Code:97138-4300
Practice Address - Country:US
Practice Address - Phone:469-474-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-10260995176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife