| Doctor Name: | MS. MELINDA ANNE HARRIS-MOULTON |
| NPI Number: | 1013296128 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, ARNP, FNP-C |
| License Number: | AP 60238471 |
| Business Practice Address: | 5201 Dolphin Ln Nw Olympia, WA - 985029226 |
| Business Phone Number: | 3608668143 |
| Business Fax Number: | |
| Mailing Address: | 5201 Dolphin Ln Nw, OLYMPIA |
| State: | WA |
| Postal Code: | 985029226 |
| Phone Number: | 3608668143 |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2011 |
| NPI Last Update Date: | 08/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP 60238471 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |