Basic Information
| Provider Information | |||||||||
| NPI: | 1396986832 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURTIS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | C.K. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., LMHC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1944 PACIFIC AVE STE 306 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984023121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538882773 | ||||||||
| FaxNumber: | 2535729958 | ||||||||
| Practice Location | |||||||||
| Address1: | 1944 PACIFIC AVE STE 306 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984023121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538882773 | ||||||||
| FaxNumber: | 2535729958 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2009 | ||||||||
| LastUpdateDate: | 01/26/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LH00010777 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.