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General NPI Number Information
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NPI Number | 1407668783
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Entity Type | Organization
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Legal Business Name | MELISA HOLDWAY, LMHC, PLLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 107 E LAKE ST. SUITE C
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City | MEDICAL LAKE
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State | WA
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Zip | 99022
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Country | US
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Telephone | 509-721-0290
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Fax | 509-565-3025
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Provider Business Mailing Address
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Address Line | PO BOX 997
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City | MEDICAL LAKE
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State | WA
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Zip | 99022-0997
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Country | US
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Telephone | 509-721-0290
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Fax | 509-565-3025
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Authorized Official
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Title or Position | OWNER
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Name | MELISA RENAE HOLDWAY
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Credential | LMHC
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Telephone | 509-844-4758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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