Mack, Melissa Kathryn

Mack, Melissa Kathryn is an individual health care provider with primary practice located at 2525 Ne 139Th St , Vancouver WA 98686-2719. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Mack, Melissa Kathryn can be contacted via phone (360) 397-3870.

Contact Information

Primary practice address
2525 Ne 139Th St Vancouver WA 98686-2719
Phone: (360) 397-3870
Fax: (360) 397-3858
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X AP30007582 Washington
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X Oregon

Profile Details

NPI number 1124052006
LBN Legal business name Mack, Melissa Kathryn
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Feb 26th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124052006 NPPES
Washington MEDICAID 9651506
Washington MEDICAID 269690

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