Provider Demographics
NPI:1447373154
Name:MERRIAM, THOMAS SCOTT (CPED)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:SCOTT
Last Name:MERRIAM
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1612
Mailing Address - Country:US
Mailing Address - Phone:541-386-4134
Mailing Address - Fax:541-386-4155
Practice Address - Street 1:1204 13TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1612
Practice Address - Country:US
Practice Address - Phone:541-386-4134
Practice Address - Fax:541-386-4155
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist