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General NPI Number Information
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NPI Number | 1164899316
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Entity Type | Individual
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Provider Name | MELISSA J SPENCER ARNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 14410 SE PETROVITSKY RD STE 209
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City | RENTON
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State | WA
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Zip | 98058-8900
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Country | US
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Telephone | 425-578-9505
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Fax | 425-578-9505
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Provider Business Mailing Address
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Address Line | 14410 SE PETROVITSKY RD STE 209
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City | RENTON
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State | WA
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Zip | 98058-8900
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Country | US
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Telephone | 425-578-9505
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Fax | 425-207-4967
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 7421827-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60920612
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License Number State | WA
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