Provider Demographics
NPI:1295884005
Name:DENMARK, MELISSA A (LM)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:DENMARK
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5719 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-5013
Mailing Address - Country:US
Mailing Address - Phone:206-724-5303
Mailing Address - Fax:
Practice Address - Street 1:57 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2929
Practice Address - Country:US
Practice Address - Phone:877-869-6105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2010-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00000286176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife