Provider Demographics
NPI:1164783320
Name:ENRIQUEZ, MELISSA JANE SUNGA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA JANE
Middle Name:SUNGA
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10116 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4148
Mailing Address - Country:US
Mailing Address - Phone:206-250-6148
Mailing Address - Fax:425-990-2444
Practice Address - Street 1:3550 FACTORIA BLVD SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-6126
Practice Address - Country:US
Practice Address - Phone:425-378-0202
Practice Address - Fax:425-378-0225
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH0231114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH0231114OtherPHARMACIST LICENCE