Individual
MRS. MELISSA R OTTENBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
450 S KITSAP BLVD, STE 2300, PORT ORCHARD, WA 98366-3773
(360) 895-0216
(360) 895-7919
Mailing address
9951 MICKELBERRY RD NW, STE 101, SILVERDALE, WA 98383-8309
(360) 692-9362
(360) 392-6214
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP60103856
WA
364SP0200X
Pediatric Clinical Nurse Specialist
RN00167987
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9662412
—
WA
01
—
AP60103856
ARNP LICENSE
WA
01
—
RN00167987
RN
WA
Enumeration date
11/02/2005
Last updated
03/07/2023
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