MS. MELISSA C PETTINI (NPI# 1295367886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295367886 |
| Entity Type | Individual |
| Full Name | MS. MELISSA C PETTINI |
| Credential | ARNP |
| Practice Address |
317 Martin Luther King Jr Way Tacoma WA 98405-4234 |
| Practice Telephone | 9784031418 |
| Mailing Telephone | 9784031418 |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
RN60345209 | WA | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP61058265 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
317 MARTIN LUTHER KING JR WAY |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720057300 | Elizabeth Nuhn Hasert | Pediatrics | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2006-03-16 |
| 1598381709 | Rachel Barrett | Dietitian, Registered | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-06-23 |
| 1124513718 | Katrina Lynn Sterling | Registered Nurse | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2018-06-26 |
| 1699263764 | Cheyenne Dewey | Genetic Counselor, MS | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2018-04-24 |
| 1386187151 | Heidi Kathleen Vladyka | Occupational Therapist | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2016-11-28 |
| 1215309414 | Molly Rooy | Dietitian, Registered | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2015-10-27 |
| 1730573478 | Luke Warnken | Specialist/Technologist | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2015-03-19 |
| 1821391210 | Jodi Sacken | Physician Assistant | 317 Martin Luther King Jr Way, Tacoma, WA 98405 | 2010-12-07 |
| 1255652731 | Ashley T Jones | Pediatrics | 317 Martin Luther King Jr Way, Mary Bridge Children's Hospital, Tacoma, WA 98405 | 2010-06-18 |
| 1063739936 | Mary Bridge Children's Hospital | General Acute Care Hospital | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2010-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942435706 | Teresa Michelle Poole | Nurse Practitioner | 9040a Jackson Ave Madigan Army Medical Center Jblm, Tacoma, WA 98431-6307 | 2009-05-22 |
| 1376757906 | Keri Orozco | Nurse Practitioner | 603 S J St, Tacoma, WA 98405-4159 | 2007-05-10 |
| 1265571871 | Margaret Joan Williams | Nurse Practitioner | Of Pediatrics, Mamc, Tacoma, WA 98431-0001 | 2007-02-06 |
| 1154306504 | Eileen T Huhmann | Nurse Practitioner | 690 A St, Mccord Afb, Tacoma, WA 98438-1303 | 2005-12-08 |
| 1154964815 | Alexis Christine Themelis Balser | Nurse Practitioner | 11601 Pacific Ave S, Tacoma, WA 98444-5425 | 2019-10-24 |
| 1134638976 | Denise Quinn Parra | Nurse Practitioner | 311 S L St, Tacoma, WA 98405-3720 | 2017-09-25 |
| 1376916213 | Jennifer Steel | Nurse Practitioner | 9040 Jackson Ave, Tacoma, WA 98431-3089 | 2015-10-31 |
| 1659773109 | Allyson Marie Stoker | Nurse Practitioner | 311 S L St, Tacoma, WA 98405-3720 | 2014-09-16 |
| 1730517244 | Courtney Ann Weyand | Nurse Practitioner | 311 S L St, Tacoma, WA 98405-3720 | 2013-10-18 |
| 1790119675 | Raquel Marisol Bolender | Nurse Practitioner | 1530 S Union Ave, Tacoma, WA 98405-1954 | 2013-08-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.