Individual
MELISSA LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1780 NW MYHRE RD, SILVERDALE, WA 98383-8676
(360) 782-3100
(360) 782-3112
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00039970
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150782
LABOR & INDUSTRIES
WA
01
—
160052725
RAILROAD MEDICARE
—
01
—
1918RA
REGENCE BLUE SHIELD
—
01
—
7098018
AETNA
—
05
—
8277927
—
WA
01
—
8943766
CRIME VICTIMS COMP
WA
Enumeration date
06/23/2006
Last updated
03/07/2023
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