Provider Demographics
NPI:1427007434
Name:BEHRENS, MELINDA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:LOUISE
Last Name:BEHRENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2148 HUNTINGTON LOOP SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-3490
Mailing Address - Country:US
Mailing Address - Phone:253-968-3066
Mailing Address - Fax:253-968-0384
Practice Address - Street 1:2148 HUNTINGTON LOOP SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98513-3490
Practice Address - Country:US
Practice Address - Phone:360-456-0912
Practice Address - Fax:253-968-0384
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00036803208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics