Healthcare Provider Details

I. General information

NPI: 1629951231
Provider Name (Legal Business Name): MELINDA S BISHOP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 NE OLD BELFAIR HWY
BELFAIR WA
98528-9637
US

IV. Provider business mailing address

PO BOX 277
BELFAIR WA
98528-0277
US

V. Phone/Fax

Practice location:
  • Phone: 360-275-6711
  • Fax: 833-909-3994
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70029259
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: