Provider Demographics
NPI:1265040547
Name:MOULD, MELVIN LEROY II (CERTIFIED INTERPRETE)
Entity Type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:LEROY
Last Name:MOULD
Suffix:II
Gender:M
Credentials:CERTIFIED INTERPRETE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 BOULEVARD RD SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1917
Mailing Address - Country:US
Mailing Address - Phone:360-790-2780
Mailing Address - Fax:360-915-9040
Practice Address - Street 1:912 BOULEVARD RD SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1917
Practice Address - Country:US
Practice Address - Phone:360-790-2780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC7753171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter