Provider Demographics
NPI:1245418375
Name:HADFIELD, MELISSA LYNN (LSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:HADFIELD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 24TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3626
Mailing Address - Country:US
Mailing Address - Phone:206-948-8273
Mailing Address - Fax:
Practice Address - Street 1:1208 24TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3626
Practice Address - Country:US
Practice Address - Phone:206-948-8273
Practice Address - Fax:253-288-2203
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000090641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA602783374OtherUBI NUMBER