Healthcare Provider Details

I. General information

NPI: 1265250328
Provider Name (Legal Business Name): MELANIE SIMPSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 STATE AVE NE
OLYMPIA WA
98506-3984
US

IV. Provider business mailing address

711 STATE AVE NE
OLYMPIA WA
98506-3984
US

V. Phone/Fax

Practice location:
  • Phone: 360-918-7860
  • Fax: 360-584-9265
Mailing address:
  • Phone: 360-918-7860
  • Fax: 360-584-9265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF70076931
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: