Provider Demographics
NPI:1871853804
Name:CADWELL MEYER, MARIE-ELISE MIDTHUN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIE-ELISE
Middle Name:MIDTHUN
Last Name:CADWELL MEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARIE-ELISE
Other - Middle Name:MIDTHUN
Other - Last Name:CADWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:940 NORTHGATE DR.
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-942-2516
Mailing Address - Fax:509-942-2527
Practice Address - Street 1:940 NORTHGATE DR.
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-942-2516
Practice Address - Fax:509-942-2527
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60419232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8946078Medicare PIN