Healthcare Provider Details

I. General information

NPI: 1568725612
Provider Name (Legal Business Name): MELISSA FONTENOT FRANCIK R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 SE BISHOP BLVD STE 130
PULLMAN WA
99163-5517
US

IV. Provider business mailing address

2002 HOLCOMBE BLVD NFS 120
HOUSTON TX
77030-4211
US

V. Phone/Fax

Practice location:
  • Phone: 509-336-7543
  • Fax:
Mailing address:
  • Phone: 713-791-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT82089
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI60416009
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: