Provider Demographics
NPI:1093113060
Name:MELSNESS, AMY
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:MELSNESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 N DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4454
Mailing Address - Country:US
Mailing Address - Phone:808-652-8654
Mailing Address - Fax:
Practice Address - Street 1:325 E 3RD AVE STE B
Practice Address - Street 2:
Practice Address - City:KETTLE FALLS
Practice Address - State:WA
Practice Address - Zip Code:99141-9551
Practice Address - Country:US
Practice Address - Phone:509-640-3288
Practice Address - Fax:509-651-1915
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015871172M00000X
HI262175F00000X
CAND704175F00000X
WANT60534616175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No172M00000XOther Service ProvidersMechanotherapist