Provider Demographics
NPI:1770199747
Name:FRINGUELLO, MELANIE ELISE (MD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ELISE
Last Name:FRINGUELLO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ELISE
Other - Last Name:RANSOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST BOX 356460
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST BOX 356460
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-2541
Practice Address - Country:US
Practice Address - Phone:206-598-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
COCSW.099251211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program