Provider Demographics
NPI:1447243381
Name:MERKLEY, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:MERKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 GOETHALS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3552
Mailing Address - Country:US
Mailing Address - Phone:509-943-3196
Mailing Address - Fax:509-946-0455
Practice Address - Street 1:945 GOETHALS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3552
Practice Address - Country:US
Practice Address - Phone:509-943-3196
Practice Address - Fax:509-946-0455
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00028474207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61869OtherL & I
WA1066547Medicaid
WA1066547Medicaid
E87089Medicare UPIN