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General NPI Number Information
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NPI Number | 1144009119
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Entity Type | Individual
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Provider Name | MELISSA PORTNOY ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 390 FOUNDERS WAY
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City | FORKS
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State | WA
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Zip | 98331-9062
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Country | US
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Telephone | 360-374-6998
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Fax | 360-374-3162
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Provider Business Mailing Address
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Address Line | 530 BOGACHIEL WAY
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City | FORKS
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State | WA
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Zip | 98331-9120
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Country | US
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Telephone | 360-374-6271
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN60565637
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61499144
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License Number State | WA
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