MEDICARE: MELISSA SARA JANE ANDERSON CRNP

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	363LF0000X	Family Nurse Practitioner	1-073968	AL

General Provider Information

NPI Number	:	1689897167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA SARA JANE ANDERSON CRNP

Provider Business Mailing Address
First Line	:	120 STATE AVE NE
Second Line	:	#180
City	:	OLYMPIA
State	:	WA
Zip	:	98501-1131
Country	:	US
Telephone Number	:	360-890-6306
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 STATE AVE NE
Second Line	:	#180
City	:	OLYMPIA
State	:	WA
Zip	:	98501-1131
Country	:	US
Telephone Number	:	360-890-6306
Fax Number	:

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	12/21/2025

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