Provider Demographics
NPI:1841554334
Name:THOMPSON, MELISSA JANE
Entity type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:JANE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23722 NE 192ND WAY
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-6773
Mailing Address - Country:US
Mailing Address - Phone:206-779-6281
Mailing Address - Fax:425-788-3617
Practice Address - Street 1:23722 NE 192ND WAY
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-6773
Practice Address - Country:US
Practice Address - Phone:206-779-6281
Practice Address - Fax:425-788-3617
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602315750374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula