Provider Demographics
NPI:1003016692
Name:NORWOOD, MELODY E (LMP)
Entity Type:Individual
Prefix:MISS
First Name:MELODY
Middle Name:E
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 BRIDGEPORT WAY W
Mailing Address - Street 2:SUITE1-D
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4700
Mailing Address - Country:US
Mailing Address - Phone:253-564-6747
Mailing Address - Fax:253-566-9104
Practice Address - Street 1:2607 BRIDGEPORT WAY W
Practice Address - Street 2:SUITE1-D
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4700
Practice Address - Country:US
Practice Address - Phone:253-564-6747
Practice Address - Fax:253-566-9104
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016792174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0217989OtherL&I