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General NPI Number Information
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NPI Number | 1467670794
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Entity Type | Individual
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Provider Name | MELISSA A PRASATIK PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10117 NE 58TH ST STE 200
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City | KIRKLAND
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State | WA
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Zip | 98033-7450
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Country | US
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Telephone | 425-821-6363
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Fax | 425-821-4804
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Provider Business Mailing Address
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Address Line | 5310 HARVEST HILL RD STE 290
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City | DALLAS
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State | TX
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Zip | 75230-5826
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Country | US
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Telephone | 214-420-0650
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Fax | 214-736-0512
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60388636
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License Number State | WA
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