Provider Demographics
NPI:1376930826
Name:MORROW, MELISSA JOAN (LMP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOAN
Last Name:MORROW
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 1:1205 N 10TH PL
Mailing Address - Street 2:2538
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5631
Mailing Address - Country:US
Mailing Address - Phone:253-266-3114
Mailing Address - Fax:
Practice Address - Street 1:3800 S EDDY ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3136
Practice Address - Country:US
Practice Address - Phone:206-709-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60303873172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker