Provider Demographics
NPI:1689066763
Name:HILL, MELISSA JO (MA, SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JO
Last Name:HILL
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JO
Other - Last Name:STARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25117 SW PARKWAY AVE
Mailing Address - Street 2:STE D
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 AARON DR
Practice Address - Street 2:
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-8516
Practice Address - Country:US
Practice Address - Phone:360-354-5985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60453959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist