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NPI Code Detail

MEDICARE: MELISSA GLICK P.A.

MEDICARE: MELISSA GLICK P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1131OK

General Provider Information

NPI Number : 1730178567
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA GLICK P.A.
Provider Business Mailing Address
First Line : 201 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5226
Country : US
Telephone Number : 206-326-3000
Fax Number :
Provider Business Practice Location Address
First Line : 201 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5226
Country : US
Telephone Number : 206-326-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 04/07/2021

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Directions to “ MELISSA GLICK P.A.” Practice Location

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