MEDICARE: DR. MELISSA CAHOON DDS

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	122300000X	Dentist	60867293	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60867293	OTHER	WA	DENTIST LICENSE

General Provider Information

NPI Number	:	1841778727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA CAHOON DDS

Provider Business Mailing Address
First Line	:	8118 GREEN LAKE DR N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4412
Country	:	US
Telephone Number	:	206-525-4994
Fax Number	:

Provider Business Practice Location Address
First Line	:	8118 GREEN LAKE DR N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4412
Country	:	US
Telephone Number	:	206-525-4994
Fax Number	:

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

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	08/18/2020

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