Active NPI
Melanie Tison
- Licensed Practical Nurse
- Buckley, WA
National Provider Identifier
1598308397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP00054717
- Practice address
- 340 White River Park Rd
Buckley, WA 98321 - Phone
- (360) 829-5919
- NPI assigned
- Oct 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP00054717 | WA | Primary |
Addresses
Primary practice location
340 White River Park Rd
Buckley, WA 98321
Mailing address
12003 258TH Ave CT E
Buckley, WA 98321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP00054717 | WA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1598308397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12003 258TH AVE CT E",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "98321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 WHITE RIVER PARK RD",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "98321",
"telephone_number": "360-829-5919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISON",
"first_name": "MELANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-24",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP00054717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckley, WA
- Supplemental Health Care
- Maua Wingi Swai, ARNP, FNP-C, PMHNP
- Adam John Tabet, M.D.
- Heather Thomas
- Paul Warner Thompson, PHARM.D.
- Robyn Toy
- Casandra Faith Capon Tran, ARNP
- Charla Travis
- Washington State Department of Social and Health Services (Rainier School Pharmacy)
- Mesa Eva Kate Webb, M.S., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.