Provider Demographics
NPI:1104463355
Name:MILLS, MELANIE KIMIYO
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:KIMIYO
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:KIMIYO
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1046 MOUNTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4150
Mailing Address - Country:US
Mailing Address - Phone:707-689-4647
Mailing Address - Fax:
Practice Address - Street 1:600 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3686
Practice Address - Country:US
Practice Address - Phone:360-270-5946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant