Provider Information for 1912317355
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MELISSA CLEM MC60344091
Sex: Female
NPI: 1912317355
Last Updated: 2014-05-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1912317355 | ||||||||
| Enumeration Date | 2014-05-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 640 S MISSION ST WENATCHEE, WA 98801-3050 United States Phone: 509-662-6761 | Fax:509-663-3182 | ||||||||
| Primary Practice Address | 640 S MISSION ST WENATCHEE, WA 98801-3050 United States Phone: 509-662-6761 | Fax:509-663-3182 | ||||||||
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