Provider Demographics
NPI:1871125369
Name:RIES, MELODY J (MA, LMHC)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:J
Last Name:RIES
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10551 13TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-5227
Mailing Address - Country:US
Mailing Address - Phone:202-368-6848
Mailing Address - Fax:
Practice Address - Street 1:1417 NW 54TH ST STE 452
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3564
Practice Address - Country:US
Practice Address - Phone:202-368-6848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60808305101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health