Doctor Name: | MRS. MOLLY ANNETTE DUTTON MELLON |
NPI Number: | 1285917930 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP60249844 |
Business Practice Address: | 21 Niederman Rd Oakville, WA - 98568 |
Business Phone Number: | 3607091737 |
Business Fax Number: | 3602737217 |
Mailing Address: | Po Box 570, 21 Niederman Rd OAKVILLE |
State: | WA |
Postal Code: | 98568 |
Phone Number: | 3607091737 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2011 |
NPI Last Update Date: | 12/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP60249844 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |