Healthcare Provider Details

I. General information

NPI: 1295015527
Provider Name (Legal Business Name): ZANDRA MAGALI MELCHOR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 STEVENS DR STE 3A
RICHLAND WA
99352-3558
US

IV. Provider business mailing address

969 STEVENS DR STE 3A
RICHLAND WA
99352-3558
US

V. Phone/Fax

Practice location:
  • Phone: 509-713-1315
  • Fax:
Mailing address:
  • Phone: 509-713-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60255524
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA 60255524
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: