Provider Demographics
NPI:1053578930
Name:KINDAHL, MELISSA LYNN (ARNP)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LYNN
Last Name:KINDAHL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:17000 140TH AVE NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6928
Mailing Address - Country:US
Mailing Address - Phone:425-483-5437
Mailing Address - Fax:425-488-4919
Practice Address - Street 1:17000 140TH AVE NE
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6928
Practice Address - Country:US
Practice Address - Phone:425-483-5437
Practice Address - Fax:425-488-4919
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60016964363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics