Provider Demographics
NPI:1427278100
Name:BRACE, MELANIE JEANNE (MD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:JEANNE
Last Name:BRACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8695 LANDING LN SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7914
Mailing Address - Country:US
Mailing Address - Phone:253-857-4804
Mailing Address - Fax:
Practice Address - Street 1:7500 OLD MILITARY RD NE STE 103
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-3242
Practice Address - Country:US
Practice Address - Phone:360-698-9258
Practice Address - Fax:360-698-9296
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000311102084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry