MEDICARE: MELANIE D SALAZAR LMP, CR

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
1	172M00000X	Mechanotherapist	MA00024938	WA

General Provider Information

NPI Number	:	1790964450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE D SALAZAR LMP, CR

Provider Business Mailing Address
First Line	:	708 N 80TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 N 80TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4312
Country	:	US
Telephone Number	:	206-335-1329
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	08/12/2011

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