Individual
MELODY WANDA MINOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
16317 25TH AVENUE CT E, TACOMA, WA 98445-4510
(253) 298-2796
Mailing address
16317 25TH AVENUE CT E, TACOMA, WA 98445-4510
(253) 298-2796
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00046678
WA
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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