Provider Demographics
NPI:1538612304
Name:RAYMOND S MELCHER
Entity type:Organization
Organization Name:RAYMOND S MELCHER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-622-2720
Mailing Address - Street 1:720 OLIVE WAY
Mailing Address - Street 2:SUITE 830
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1878
Mailing Address - Country:US
Mailing Address - Phone:206-622-2720
Mailing Address - Fax:206-624-1788
Practice Address - Street 1:720 OLIVE WAY
Practice Address - Street 2:SUITE 830
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1878
Practice Address - Country:US
Practice Address - Phone:206-622-2720
Practice Address - Fax:206-624-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental