Individual
JANE K. MELLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Mailing address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD60265218
WA
208000000X
Pediatrics Physician
ME88247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268285100
—
FL
Enumeration date
06/17/2006
Last updated
06/08/2021
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