Richmond, Mardell C

Richmond, Mardell C is an individual health care provider with primary practice located at 939 Caroline St , Port Angeles WA 98362-3909. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Richmond, Mardell C can be contacted via phone (360) 417-7000.

Contact Information

Primary practice address
939 Caroline St Port Angeles WA 98362-3909
Phone: (360) 417-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30004046 Washington

Profile Details

NPI number 1972571172
LBN Legal business name Richmond, Mardell C
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972571172 NPPES
Other 1709RI REGENCE BLUE SHIELD RIDER
MEDICAID 9634247 REGENCE BLUE SHIELD RIDER
Other P00024604 REGENCE BLUE SHIELD RIDER

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