1871853804 NPI number — DR. MARIE-ELISE MIDTHUN CADWELL MEYER D.O.

Table of content: DR. MARIE-ELISE MIDTHUN CADWELL MEYER D.O. (NPI 1871853804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871853804 NPI number — DR. MARIE-ELISE MIDTHUN CADWELL MEYER D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CADWELL MEYER
Provider First Name:
MARIE-ELISE
Provider Middle Name:
MIDTHUN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CADWELL
Provider Other First Name:
MARIE-ELISE
Provider Other Middle Name:
MIDTHUN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871853804
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
940 NORTHGATE DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-942-2516
Provider Business Mailing Address Fax Number:
509-942-2527

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
940 NORTHGATE DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-942-2516
Provider Business Practice Location Address Fax Number:
509-942-2527
Provider Enumeration Date:
05/24/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OP60419232 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com