1992029730 NPI number — MISS MELISSA KAY FORSLUND RN, BSN, CNOR

Table of content: MISS MELISSA KAY FORSLUND RN, BSN, CNOR (NPI 1992029730)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992029730 NPI number — MISS MELISSA KAY FORSLUND RN, BSN, CNOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORSLUND
Provider First Name:
MELISSA
Provider Middle Name:
KAY
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
RN, BSN, CNOR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHRISTIANSEN
Provider Other First Name:
MELISSA
Provider Other Middle Name:
KAY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN, CNOR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992029730
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13114 120TH AVE NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KIRKLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98034-3014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-821-6000
Provider Business Mailing Address Fax Number:
425-820-6288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13114 120TH AVE NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-821-6000
Provider Business Practice Location Address Fax Number:
425-820-6288
Provider Enumeration Date:
03/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WS0121X , with the licence number:  RN 00160881 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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