Provider Demographics
NPI:1538816426
Name:SAWYER, MELISSA MAYUMI (LAC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAYUMI
Last Name:SAWYER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4753 S SWADLEY ST
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-1925
Mailing Address - Country:US
Mailing Address - Phone:716-523-7482
Mailing Address - Fax:
Practice Address - Street 1:645 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4458
Practice Address - Country:US
Practice Address - Phone:720-523-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002562171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty