Healthcare Provider Details

I. General information

NPI: 1265396980
Provider Name (Legal Business Name): DAWN K MELLO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14402 MADISON WAY
LYNNWOOD WA
98087-6005
US

IV. Provider business mailing address

14402 MADISON WAY
LYNNWOOD WA
98087-6005
US

V. Phone/Fax

Practice location:
  • Phone: 360-991-1167
  • Fax:
Mailing address:
  • Phone: 360-991-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number60257245
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: