Provider Demographics
NPI:1720099690
Name:RAMSEY, MELISSA MARLEEN (DDS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARLEEN
Last Name:RAMSEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2228
Mailing Address - Country:US
Mailing Address - Phone:509-525-2787
Mailing Address - Fax:509-525-4183
Practice Address - Street 1:1750 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2228
Practice Address - Country:US
Practice Address - Phone:509-525-2787
Practice Address - Fax:509-525-4183
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5049374Medicaid