Provider Demographics
NPI:1710756473
Name:ORDWAY, MELODY S (LPN)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:S
Last Name:ORDWAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15805 NE 28TH ST RM 214
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2127
Mailing Address - Country:US
Mailing Address - Phone:812-262-9064
Mailing Address - Fax:
Practice Address - Street 1:15805 NE 28TH ST RM 214
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2127
Practice Address - Country:US
Practice Address - Phone:812-262-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32164164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse