Provider Demographics
NPI:1215007182
Name:MULNEAUX-THOMAS, MELODY KAREN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:KAREN
Last Name:MULNEAUX-THOMAS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8430 15TH PL SE
Mailing Address - Street 2:SPACE 27
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98205-1765
Mailing Address - Country:US
Mailing Address - Phone:425-397-7256
Mailing Address - Fax:
Practice Address - Street 1:8430 15TH PL SE
Practice Address - Street 2:SPACE 27
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98205-1765
Practice Address - Country:US
Practice Address - Phone:425-397-7256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007812174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist