Healthcare Provider Details

I. General information

NPI: 1528836152
Provider Name (Legal Business Name): MORIAH MELENDEZ LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 4TH AVE STE 203
KIRKLAND WA
98033-9028
US

IV. Provider business mailing address

22702 43RD DR SE
BOTHELL WA
98021-9070
US

V. Phone/Fax

Practice location:
  • Phone: 405-209-0460
  • Fax:
Mailing address:
  • Phone: 405-209-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61506403
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: