Provider Demographics
NPI:1841539483
Name:SCOTT, MERRY GAIL (RN)
Entity type:Individual
Prefix:MRS
First Name:MERRY
Middle Name:GAIL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 IMBODEN RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98611-9641
Mailing Address - Country:US
Mailing Address - Phone:360-274-5997
Mailing Address - Fax:
Practice Address - Street 1:303 IMBODEN RD
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:WA
Practice Address - Zip Code:98611-9641
Practice Address - Country:US
Practice Address - Phone:360-274-5997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00049539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse