Provider Demographics
NPI:1578312559
Name:GOOD, MELISSA L (STATE CERTIFIED BIRT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:L
Last Name:GOOD
Suffix:
Gender:F
Credentials:STATE CERTIFIED BIRT
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:BIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10251 RIDGELINE DRIVE
Mailing Address - Street 2:#A348
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:509-438-0787
Mailing Address - Fax:
Practice Address - Street 1:10251 RIDGELINE DRIVE
Practice Address - Street 2:#A348
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338
Practice Address - Country:US
Practice Address - Phone:509-438-0787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABD61553742374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula