Healthcare Provider Details

I. General information

NPI: 1053943993
Provider Name (Legal Business Name): MELISSA ANN BARCLAY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2020
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21701 76TH AVE W STE 104
EDMONDS WA
98026-7536
US

IV. Provider business mailing address

21701 76TH AVE W STE 104
EDMONDS WA
98026-7536
US

V. Phone/Fax

Practice location:
  • Phone: 425-476-1100
  • Fax: 425-748-7782
Mailing address:
  • Phone: 425-476-1100
  • Fax: 425-748-7782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61022271
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: