Melissa Bernadette Brandon-Doerge, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00012739 Issued in WA

Practice address

1601 William Way Ste a
Mount Vernon, WA 98273-2500

Phone

(360) 424-8115

Fax

(360) 428-0104

NPI assigned

Jan 8, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Chiropractic Clinic PS

  • Chiropractor
  • Mount Vernon, WA
  • NPI 1588694863
  NPD (past)

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1396982690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WILLIAM WAY STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732500",
            "telephone_number": "360-424-8115",
            "fax_number": "360-428-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WILLIAM WAY STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732500",
            "telephone_number": "360-424-8115",
            "fax_number": "360-428-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON-DOERGE",
        "first_name": "MELISSA",
        "middle_name": "BERNADETTE",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00012739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rae Boyd, APRN
• Holly Rae Braaten, CNM
• Andrea L Bradford, LICSW
• Kathy Y Bradford, ARNP
• Abigail Bradley
• Betty Sue Branscom, RN
• Matthew Forrest Brasfield, BS, SUDPT, AAC, CPC
• Charleen Renee Bray, CDPT
• Alexandra M Braymen, PA-C
• Shelley Rene Brencick Higman, DO

• Specialist in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.