Provider Demographics
NPI:1265595375
Name:MAXWELL, MELINDA A (DC)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:A
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:6965 COAL CREEK PKWY SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3136
Mailing Address - Country:US
Mailing Address - Phone:425-641-7470
Mailing Address - Fax:425-373-9176
Practice Address - Street 1:6965 COAL CREEK PKWY SE
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98059-3136
Practice Address - Country:US
Practice Address - Phone:425-641-7470
Practice Address - Fax:425-373-9176
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA150928OtherLABOR AND INDUSTRIES
WA8914556OtherCRIME VICTIMS
WA150928OtherLABOR AND INDUSTRIES