Individual
MRS. MELANIE JANE MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1296 E POLSTON AVE STE C, POST FALLS, ID 83854-5217
(208) 625-6700
(208) 625-6701
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-6700
(208) 625-6701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1827
ID
363A00000X
Physician Assistant
Primary
PA1827
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS56802
CONTROLLED SUBSTANCE
ID
Enumeration date
10/23/2018
Last updated
07/28/2025
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