Healthcare Provider Details

I. General information

NPI: 1477907384
Provider Name (Legal Business Name): MELISSA CHUBBUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2016
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

INCORP SERVICES 1500 N GRANT ST STE B
DENVER CO
80203
US

IV. Provider business mailing address

600 1ST AVE STE 330
SEATTLE WA
98104-2246
US

V. Phone/Fax

Practice location:
  • Phone: 206-657-6218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD61054939
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: