Healthcare Provider Details

I. General information

NPI: 1972068500
Provider Name (Legal Business Name): MELINDA RENEE WILLIARD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELINDA MITCHELL RN

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4304 W CHESTNUT AVE
YAKIMA WA
98908-3257
US

IV. Provider business mailing address

501 S 5TH AVE
YAKIMA WA
98902-3550
US

V. Phone/Fax

Practice location:
  • Phone: 509-823-4200
  • Fax: 509-823-4200
Mailing address:
  • Phone: 509-853-1082
  • Fax: 509-573-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70045890
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60389132
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: