Provider Demographics
NPI:1295042380
Name:LEFEVRE, MELANIE C (LMP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:C
Last Name:LEFEVRE
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 1:22824 NE 76TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-7989
Mailing Address - Country:US
Mailing Address - Phone:425-868-9064
Mailing Address - Fax:
Practice Address - Street 1:22824 NE 76TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-7989
Practice Address - Country:US
Practice Address - Phone:425-868-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60182377174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist