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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124052006 | NPPES |
| Washington | MEDICAID | 9651506 | |
| Washington | MEDICAID | 269690 |
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