Provider Demographics
NPI:1902918600
Name:HENDRICKSON, MELINDA ANNE (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANNE
Last Name:HENDRICKSON
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 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:FA.2.113 NEONATOLOGY PO BOX 5371
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-4199
Mailing Address - Fax:206-987-2685
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:FA.2.113 NEONATOLOGY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-4199
Practice Address - Fax:206-987-2685
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD214202080N0001X
WAMD000368972080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine