Healthcare Provider Details

I. General information

NPI: 1629993688
Provider Name (Legal Business Name): MS. MELISSA MARIE WEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 31ST AVE NE STE 101
TULALIP WA
98271-7423
US

IV. Provider business mailing address

6330 31ST AVE NE STE 101
TULALIP WA
98271-7423
US

V. Phone/Fax

Practice location:
  • Phone: 360-716-2200
  • Fax: 360-716-2211
Mailing address:
  • Phone: 360-716-2200
  • Fax: 360-716-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: