Provider Demographics
NPI:1346504487
Name:DAILEY, MELISSA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:DAILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:MATHIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8851 E TRENT AVE
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2332
Mailing Address - Country:US
Mailing Address - Phone:509-924-9052
Mailing Address - Fax:509-924-6538
Practice Address - Street 1:8851 E TRENT AVE
Practice Address - Street 2:
Practice Address - City:MILLWOOD
Practice Address - State:WA
Practice Address - Zip Code:99212-2332
Practice Address - Country:US
Practice Address - Phone:509-924-9052
Practice Address - Fax:509-924-6538
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60021556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist