J Semmes Mickelwait MD Ps
NPI #1114950375 in Mount Vernon, Washington
Provider Information
- NPI Number
- 1114950375
- Entity Type
- Organization
- Organization Name
- J Semmes Mickelwait MD Ps
- Primary Specialty
- Dermatology
- Enumeration Date
- Jul 9, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1420 ROOSEVELT AVE
- Address 2
- SUITE 7
- City
- Mount Vernon
- State
- Washington
- ZIP Code
- 98273-2687
- Phone
- (360) 424-4186
Authorized Official
- Name
- J SEMMES MICKELWAIT, MD
- Title
- OWNER
- Phone
- (360) 424-4186
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology |
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