Individual provider Active NPI

Maria Cristine Melvin, ARNP

  • Primary Care Nurse Practitioner
  • Port Angeles, WA
National Provider Identifier
1679171367
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP61099325 Issued in WA
Practice address
240 W Front St Ste a
Port Angeles, WA 98362-2609
Phone
(360) 452-7891
Fax
(360) 452-8087
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP61099325 WA Primary

Addresses

Primary practice location

240 W Front St Ste a
Port Angeles, WA 98362-2609

Mailing address

240 W Front St Ste a
Port Angeles, WA 98362-2609
Phone (360) 452-7891

Other practice location 1

933 E 1st St
Port Angeles, WA 98362-4012
Phone (360) 452-7891

Other identifiers 1

IdentifierTypeStateIssuer
2167808MedicaidWA

Other names 1

  • Maria Christine Thacker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201202001692 WA Practitioner - Nurse Practitioner 1951712561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Olympic Healthcare NetworkGroup PAC ID 3779895396, 31 clinicians

Practice addresses (Care Compare)

240 W Front St
Suite a
Port Angeles, WA 98362-2609
Phone (360) 452-7891

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Olympic Healthcare Network Current Accepting new patients
North Olympic Healthcare Network CurrentSince Dec 1, 2020 Accepting new patients
North Olympic Healthcare Network CurrentSince Dec 1, 2020 Accepting new patients

Locations

1026 E 1st St
Port Angeles, WA 98362
Phone (360) 452-4432

240 W Front St
Ste A
Port Angeles, WA 98362
Phone (360) 452-7891

933 E 1st St
Port Angeles, WA 98362
Phone (360) 452-4432

240 W Front St
Port Angeles, WA 98362
Phone (360) 452-7891

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1679171367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W FRONT ST STE A",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622609",
            "telephone_number": "360-452-7891",
            "fax_number": "360-452-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W FRONT ST STE A",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622609",
            "telephone_number": "360-452-7891",
            "fax_number": "360-452-8087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "933 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Port Angeles",
            "state": "WA",
            "postal_code": "983624012",
            "country_code": "US",
            "telephone_number": "360-452-7891",
            "fax_number": "360-452-8087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "MARIA",
        "middle_name": "CRISTINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61099325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2167808",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "THACKER",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.