Provider Demographics
NPI:1265826499
Name:STEARNS, MELISSA JOY (AT/L, ATC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOY
Last Name:STEARNS
Suffix:
Gender:F
Credentials:AT/L, ATC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JOY
Other - Last Name:STEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:4311 11TH AVENUE NE, SUITE 200
Mailing Address - Street 2:POC: TERRY SCOTT, PA-C
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-616-4001
Mailing Address - Fax:
Practice Address - Street 1:4311 11TH AVENUE NE, SUITE 200
Practice Address - Street 2:POC: TERRY SCOTT, PA-C
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-616-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1602925232255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer