Provider Demographics
NPI:1538267174
Name:MELLO, CAROL SCHWEIFLER (LPN)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:SCHWEIFLER
Last Name:MELLO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 BROUSE BLVD W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1516
Mailing Address - Country:US
Mailing Address - Phone:253-565-1424
Mailing Address - Fax:
Practice Address - Street 1:9600 VETERANS DR SW
Practice Address - Street 2:AMERICAN LAKE VA
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-582-8440
Practice Address - Fax:253-589-4150
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00021710174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist