Provider Demographics
NPI:1053943993
Name:BARCLAY, MELISSA ANN (ARNP)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13122 120TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3014
Mailing Address - Country:US
Mailing Address - Phone:425-678-8534
Mailing Address - Fax:425-678-8564
Practice Address - Street 1:13122 120TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3014
Practice Address - Country:US
Practice Address - Phone:425-678-8534
Practice Address - Fax:425-678-8564
Is Sole Proprietor?:No
Enumeration Date:2020-02-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61022271363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner