Healthcare Provider Details

I. General information

NPI: 1053967984
Provider Name (Legal Business Name): MELISSA VALERO FRONDOZO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9245 RAINIER AVE S
SEATTLE WA
98118-5569
US

IV. Provider business mailing address

PO BOX 3835
SEATTLE WA
98124-3835
US

V. Phone/Fax

Practice location:
  • Phone: 206-722-8444
  • Fax: 206-721-6310
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60993245
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: