Provider Demographics
NPI:1346578952
Name:HIGGINS, MELYSSA KAY (PHD)
Entity type:Individual
Prefix:DR
First Name:MELYSSA
Middle Name:KAY
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 NE 100TH ST
Mailing Address - Street 2:306
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-8012
Mailing Address - Country:US
Mailing Address - Phone:206-361-6884
Mailing Address - Fax:206-361-1598
Practice Address - Street 1:155 NE 100TH ST
Practice Address - Street 2:306
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-8012
Practice Address - Country:US
Practice Address - Phone:206-361-6884
Practice Address - Fax:206-361-1598
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002560103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist