Provider Demographics
NPI:1114634565
Name:LATOUR, MELISSA KAY
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAY
Last Name:LATOUR
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 1:917 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-8866
Mailing Address - Country:US
Mailing Address - Phone:509-930-5536
Mailing Address - Fax:
Practice Address - Street 1:620 N 34TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1500
Practice Address - Country:US
Practice Address - Phone:509-930-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide