Provider Demographics
NPI:1184002081
Name:MORRISON, MELINDA KAY (LMT)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:KAY
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 SW 327TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2759
Mailing Address - Country:US
Mailing Address - Phone:206-235-4918
Mailing Address - Fax:
Practice Address - Street 1:5929 WESTGATE BLVD STE C
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2567
Practice Address - Country:US
Practice Address - Phone:253-368-6227
Practice Address - Fax:253-409-2725
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61149835171100000X
WAMA00019138225700000X
WAAC1149835171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist