Provider Demographics
NPI:1518618883
Name:WIMMER, MELANIE FAYE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:FAYE
Last Name:WIMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 23RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2302
Mailing Address - Country:US
Mailing Address - Phone:206-328-5696
Mailing Address - Fax:
Practice Address - Street 1:1923 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1104
Practice Address - Country:US
Practice Address - Phone:206-948-5617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator