Provider Demographics
NPI:1215051834
Name:BRYAN, MELINDA L (MA)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:L
Last Name:BRYAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 HIGH ST
Mailing Address - Street 2:MS9171
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-650-3881
Mailing Address - Fax:360-650-4334
Practice Address - Street 1:516 HIGH ST
Practice Address - Street 2:MS9171
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-650-3881
Practice Address - Fax:360-650-4334
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00000971231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA99220OtherHEARPO
WA108285OtherL&I NUMBER