Healthcare Provider Details

I. General information

NPI: 1093827065
Provider Name (Legal Business Name): MR. DONALD MELENA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 VETERANS DR SW
TACOMA WA
98493-5000
US

IV. Provider business mailing address

9702 LAKE STEILACOOM DR SW
LAKEWOOD WA
98498-5711
US

V. Phone/Fax

Practice location:
  • Phone: 253-582-8440
  • Fax:
Mailing address:
  • Phone: 253-581-2610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: