Provider Demographics
NPI:1124164900
Name:MERCKER, JANIS MARYAN (MD)
Entity type:Individual
Prefix:DR
First Name:JANIS
Middle Name:MARYAN
Last Name:MERCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18009 13TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3203
Mailing Address - Country:US
Mailing Address - Phone:206-542-5407
Mailing Address - Fax:
Practice Address - Street 1:728 134TH ST SW
Practice Address - Street 2:SUITE 120
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5322
Practice Address - Country:US
Practice Address - Phone:425-297-6200
Practice Address - Fax:425-297-6250
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000162632085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology