Provider Demographics
NPI:1144358607
Name:ANDERSON, MELINDA SUE (ND)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:SUE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10807 159TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-7706
Mailing Address - Country:US
Mailing Address - Phone:360-862-1660
Mailing Address - Fax:360-568-4436
Practice Address - Street 1:10807 159TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-7706
Practice Address - Country:US
Practice Address - Phone:360-862-1660
Practice Address - Fax:360-568-4436
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT1234175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath