Melany Khamsitthisack, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

61081776 Issued in WA

Practice address

400 S 43Rd St
Renton, WA 98055-5714

Phone

(425) 228-3450

NPI assigned

Mar 24, 2022

Last updated

Mar 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1306596473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 30TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263166",
            "telephone_number": "530-215-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMSITTHISACK",
        "first_name": "MELANY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61081776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "61081776",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melany_khamsitthisack@valleymed.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "melany_khamsitthisack@valleymed.org",
            "address_1": "400 S 43rd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Renton, WA
• Providers in Renton, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.