Healthcare Provider Details

I. General information

NPI: 1972934305
Provider Name (Legal Business Name): MELINA MARIE HANDLEY CPNP-AC, ARNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE FA.2-112 SEATTLE CHILDREN'S HOSPITAL
SEATTLE WA
98145-5005
US

IV. Provider business mailing address

4800 SAND POINT WAY NE FA.2-112 SEATTLE CHILDREN'S HOSPITAL
SEATTLE WA
98145-5005
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2000
  • Fax: 206-987-3866
Mailing address:
  • Phone: 206-987-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberSP013424
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: