Provider Demographics
NPI:1770647984
Name:MERCER, PAMELA ANN (LMP, MMP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ANN
Last Name:MERCER
Suffix:
Gender:F
Credentials:LMP, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4304 N. MURRAY
Mailing Address - Street 2:PO BOX 254
Mailing Address - City:OTIS ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:99027
Mailing Address - Country:US
Mailing Address - Phone:509-226-4304
Mailing Address - Fax:509-226-3304
Practice Address - Street 1:4304 N. MURRAY
Practice Address - Street 2:
Practice Address - City:OTIS ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:99027
Practice Address - Country:US
Practice Address - Phone:509-226-4304
Practice Address - Fax:509-226-3304
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00016236OtherMASSAGE PRACTITIONER