Provider Demographics
NPI:1346491024
Name:MELANG, LEANNE MICHELLE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:LEANNE
Middle Name:MICHELLE
Last Name:MELANG
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 1:22727 HWY 99 STE 109
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8381
Mailing Address - Country:US
Mailing Address - Phone:425-774-1090
Mailing Address - Fax:425-775-9797
Practice Address - Street 1:22727 HWY 99 STE 109
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8381
Practice Address - Country:US
Practice Address - Phone:425-774-1090
Practice Address - Fax:425-775-9797
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020221225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist