Provider Demographics
NPI:1861720450
Name:WOO FOSTER, MELISSA CHI (DDS)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:CHI
Last Name:WOO FOSTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:CHI
Other - Last Name:WOO FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19916 65TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8362
Mailing Address - Country:US
Mailing Address - Phone:206-919-5253
Mailing Address - Fax:
Practice Address - Street 1:5714 134TH PL SE STE A20
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9421
Practice Address - Country:US
Practice Address - Phone:425-338-9183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60137132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist