Provider Demographics
NPI:1053330670
Name:BARNES, MELANIE H (PHD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:H
Last Name:BARNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:HOLLADAY
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1220 DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1321
Mailing Address - Country:US
Mailing Address - Phone:253-403-1685
Mailing Address - Fax:
Practice Address - Street 1:1220 DIVISION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1321
Practice Address - Country:US
Practice Address - Phone:253-403-1685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001637103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist