Provider Demographics
NPI:1801239900
Name:BOWLBY, MELINDA ANN (DPM)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANN
Last Name:BOWLBY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 NASSAU ST STE 101
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4137
Mailing Address - Country:US
Mailing Address - Phone:425-339-8888
Mailing Address - Fax:425-258-6933
Practice Address - Street 1:3131 NASSAU ST STE 101
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4137
Practice Address - Country:US
Practice Address - Phone:425-339-8888
Practice Address - Fax:425-258-6933
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO60713354213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery