Provider Demographics
NPI:1427500362
Name:ELWING, MELISSA (LMT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ELWING
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8621 N DIVISION ST
Mailing Address - Street 2:#A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5943
Mailing Address - Country:US
Mailing Address - Phone:509-468-5247
Mailing Address - Fax:509-319-2477
Practice Address - Street 1:8621 N DIVISION ST
Practice Address - Street 2:#A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5943
Practice Address - Country:US
Practice Address - Phone:509-468-5247
Practice Address - Fax:509-319-2477
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60633181225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist