Provider Demographics
NPI:1336396423
Name:GALVAN, MELANIE A (LMP, RH)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:A
Last Name:GALVAN
Suffix:
Gender:F
Credentials:LMP, RH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 S MACARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1823
Mailing Address - Country:US
Mailing Address - Phone:253-389-4077
Mailing Address - Fax:253-212-1878
Practice Address - Street 1:706 MARKET ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3712
Practice Address - Country:US
Practice Address - Phone:253-473-7830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60012018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist