Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD00046168 | WA |
NPI | 1104014364 |
---|---|
Provider Name | Sarah B Merrifield |
First Address | Portland, OR 97208-3505 |
Second Address | Olympia, WA 98506-5133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2007 |
Last Update Date | 18/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD00046168 | STATE LICENSE (01) | WA |