Provider Demographics
NPI:1629879457
Name:EVJEN, MELANIE (LICSWA)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:EVJEN
Suffix:
Gender:F
Credentials:LICSWA
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:KEDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:902 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99260-2002
Mailing Address - Country:US
Mailing Address - Phone:509-477-6383
Mailing Address - Fax:
Practice Address - Street 1:902 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99260-2002
Practice Address - Country:US
Practice Address - Phone:509-477-6383
Practice Address - Fax:509-477-2496
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61490240104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker