Provider Demographics
NPI:1326672569
Name:KONRAT, MELISSA JADE (CPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JADE
Last Name:KONRAT
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:JOANIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5325
Mailing Address - Country:US
Mailing Address - Phone:206-464-3923
Mailing Address - Fax:
Practice Address - Street 1:316 BROADWAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5325
Practice Address - Country:US
Practice Address - Phone:206-464-3923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist