Provider Demographics
NPI:1164976205
Name:MELNIK, TATYANA (ARNP)
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:MELNIK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10610 NE 9TH PL UNIT 1900
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8647
Mailing Address - Country:US
Mailing Address - Phone:425-505-8007
Mailing Address - Fax:
Practice Address - Street 1:10610 NE 9TH PL UNIT 1900
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-8647
Practice Address - Country:US
Practice Address - Phone:425-505-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60683417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily