Melissa Anne Forouhar, MD

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

MD60949136 Issued in WA

Practice address

Madigan Army Medical Ctr 9040 Jackson Ave
Tacoma, WA 98431-1110

Phone

(253) 968-1110

NPI assigned

Sep 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Melissa Anne Mazur Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1831291376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311110",
            "telephone_number": "253-968-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311110",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOROUHAR",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "OH",
            "license": "35080075",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WA",
            "license": "MD60949136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MAZUR",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teresa A. Fordyce, PA-C
• Webster Wyatt Foreman III, L.M.T.
• Forever Changed Foundation
• Selena Ann Forgey, LMP
• Clinton James Foriska, DO
• Samantha Forsberg
• Elizabeth A Forseth
• Shawn L. Forsman, LCSW
• Robert Douglas Forsten, D.O.
• Margo Jane Forstrom, RPH, MPH

• Pediatric Hematology & Oncology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Pediatric Hematology & Oncology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.