Active NPI
Melissa Mae Waud, PT, DPT
- Physical Therapist
- Renton, WA
National Provider Identifier
1942669742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60624102
- Practice address
- 451 Duvall Ave NE
Suite 200
Renton, WA 98059-4675 - Phone
- (425) 235-9505
- NPI assigned
- Feb 22, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60624102 | WA | Primary |
Addresses
Primary practice location
451 Duvall Ave NE
Suite 200
Renton, WA 98059-4675
Mailing address
750 Marvin Rd
Tillamook, OR 97141-9808
Phone (503) 812-4163
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60624102 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1942669742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 MARVIN RD",
"city": "TILLAMOOK",
"state": "OR",
"postal_code": "971419808",
"telephone_number": "503-812-4163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 DUVALL AVE NE",
"address_2": "SUITE 200",
"city": "RENTON",
"state": "WA",
"postal_code": "980594675",
"telephone_number": "425-235-9505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAUD",
"first_name": "MELISSA",
"middle_name": "MAE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-22",
"last_updated": "2020-06-12",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60624102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.