MR. GARY JOHN CLINTON MERSEREAU BSN RN NPI 1114542065

NPI Information

  • NPI: 1114542065
  • Provider Name: MR. GARY JOHN CLINTON MERSEREAU, BSN, RN
  • Classification: Registered Nurse - 163WE0003X
  • Specialization: Emergency
  • Entity Type: Individual
  • Address: 914 S SCHEUBER RD
    CENTRALIA, WA
    ZIP 98531
  • Phone: (360) 330-8785

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NPI Details

MR. Gary John Clinton Mersereau, BSN, RN is an emergency registered nurse in Centralia, WA. MR. Gary John Clinton Mersereau, BSN, RN NPI is 1114542065. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

914 S SCHEUBER RD
CENTRALIA, WA
ZIP 98531-027
Phone: (360) 330-8785

The enumeration date for this NPI number is 6/16/2020 and was last updated on 6/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WE0003XRegistered NurseEmergencyRN60383846WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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