Provider Demographics
NPI:1366684375
Name:MANIX, MELISSA AMBER (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:AMBER
Last Name:MANIX
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W HARRISON ST
Mailing Address - Street 2:SOUTH TOWER, SUITE 330
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-4116
Mailing Address - Country:US
Mailing Address - Phone:206-283-3000
Mailing Address - Fax:
Practice Address - Street 1:100 W HARRISON ST
Practice Address - Street 2:SOUTH TOWER, SUITE 330
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4116
Practice Address - Country:US
Practice Address - Phone:206-283-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA020704SW400021651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical