Individual
MELISSA M VANTASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 112TH AVE NE STE C160, BELLEVUE, WA 98004-3742
(425) 453-1039
(425) 453-8955
Mailing address
1200 112TH AVE NE STE C160, BELLEVUE, WA 98004-3742
(425) 453-1039
(425) 453-8955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
38267
CO
207Q00000X
Family Medicine Physician
Primary
60180416
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18806848
—
CO
Enumeration date
11/21/2005
Last updated
04/18/2018
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