Provider Demographics
NPI:1336753656
Name:HUSSEY, MELISSA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21529 NE 101ST ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-7671
Mailing Address - Country:US
Mailing Address - Phone:425-802-2125
Mailing Address - Fax:
Practice Address - Street 1:7525 166TH AVE NE # D225
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7828
Practice Address - Country:US
Practice Address - Phone:425-883-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61047519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist