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Individual
DR. LAURA MELLICK
Active
Individual
DR. LAURA MELLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD17993
OR
208D00000X
General Practice Physician
Primary
MD17993
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057252
—
OR
01
—
208975
WA L & I
—
05
—
8182214
—
WA
01
—
858543007
REGENCE BC/BS
—
Enumeration date
04/10/2006
Last updated
09/06/2012
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