Provider Demographics
NPI:1689919565
Name:CRANE, MELANIE (LMP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CRANE
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 1:1030 N CENTER PKWY
Mailing Address - Street 2:#319
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7160
Mailing Address - Country:US
Mailing Address - Phone:509-591-6210
Mailing Address - Fax:509-222-2223
Practice Address - Street 1:1030 N CENTER PKWY
Practice Address - Street 2:#319
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7160
Practice Address - Country:US
Practice Address - Phone:509-591-6210
Practice Address - Fax:509-222-2223
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60238713172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist