MEDICARE: MELISSA BENCOMO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN61679899	WA
2	171M00000X	Case Manager/Care Coordinator	RN.RN.61679899	WA

General Provider Information

NPI Number	:	1265386601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA BENCOMO

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8915 14TH AVE S FL 3
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-4813
Country	:	US
Telephone Number	:	206-766-6598
Fax Number	:	206-764-0523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	05/26/2026

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Directions to “ MELISSA BENCOMO ” Practice Location

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