Provider Demographics
NPI:1891921839
Name:JANKO, MELISSA MARGARET (LMP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARGARET
Last Name:JANKO
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 1:5160 S CUSHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-4254
Mailing Address - Country:US
Mailing Address - Phone:253-732-9829
Mailing Address - Fax:
Practice Address - Street 1:5160 S CUSHMAN AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-4254
Practice Address - Country:US
Practice Address - Phone:253-732-9829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00015864172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist