Provider Demographics
NPI:1912377292
Name:MELTON, ASHLEY (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MELTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:KARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8630 164TH AVE NE STE 203
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1906
Mailing Address - Country:US
Mailing Address - Phone:425-658-4980
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:8630 164TH AVE NE STE 203
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1906
Practice Address - Country:US
Practice Address - Phone:425-658-4980
Practice Address - Fax:630-759-9510
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60573142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist