Provider Demographics
NPI:1407664808
Name:NOSTER, MELODY IRENE (MSW,LICSWA)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:IRENE
Last Name:NOSTER
Suffix:
Gender:F
Credentials:MSW,LICSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-1265
Mailing Address - Country:US
Mailing Address - Phone:360-689-4247
Mailing Address - Fax:
Practice Address - Street 1:4005 N COOK ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5879
Practice Address - Country:US
Practice Address - Phone:509-530-4230
Practice Address - Fax:509-530-4235
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61602433101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health