Melissa Marie Waller, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO 60669921 Issued in WA

Practice address

390 E Cedar St
Sequim, WA 98382-3403

Phone

(360) 681-8463

Fax

(360) 683-8465

NPI assigned

Apr 18, 2017

Sex

Female

Sole proprietor

No

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.

• Olympic Personal Growth Center

  • Community/Behavioral Health Agency
  • Sequim, WA
  • NPI 1649447681
  NPD (past)
• Olympic Personal Growth Center LLC

  • Community/Behavioral Health Agency
  • Sequim, WA
  • NPI 1982726071
  NPD (past)

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1588198378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E CEDAR ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823403",
            "telephone_number": "360-681-8463",
            "fax_number": "360-683-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E CEDAR ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823403",
            "telephone_number": "360-681-8463",
            "fax_number": "360-683-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO 60669921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Stefanie G Walker-Leu, FNP
• Connie M Walker, P.A.-C.
• Linda Marie Wall, RDH
• Lauren Wallenfang, MA60397425
• Monica Walls, M.S.
• Walmart Inc.
• Gretchen T Wambach, PA-C
• Rebecca Marie Ward, PHARMD
• Kimberly Louis Washburn, SUDPT

• Addiction (Substance Use Disorder) Counselor in Sequim, WA
• Providers in Sequim, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.