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Individual

MELISSA JAYNE FAIRSHTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.P

Contact information

Practice address
136 102ND AVE SE, BELLEVUE, WA 98004-8134
(425) 455-0669
Mailing address
5639 16TH AVE SW, SEATTLE, WA 98106-1459
(206) 437-6529

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60197240
WA

Other

Enumeration date
05/11/2011
Last updated
05/11/2011
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