Healthcare Provider Details

I. General information

NPI: 1316566623
Provider Name (Legal Business Name): ALINA A. MELNYK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 14TH AVE SE
PUYALLUP WA
98372-3718
US

IV. Provider business mailing address

10819 SE 244TH PL
KENT WA
98030-0714
US

V. Phone/Fax

Practice location:
  • Phone: 425-744-1527
  • Fax:
Mailing address:
  • Phone: 253-737-7319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: