| Jane K Mellott, MD | |
|
209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 | |
| (253) 596-3300 | |
| Not Available |
| Full Name | Jane K Mellott |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 209 Martin Luther King Jr Way, Tacoma, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447295233 | NPI | - | NPPES |
| 268285100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | ME88247 (Florida) | Secondary |
| 208000000X | Pediatrics | MD60265218 (Washington) | Primary |
| Entity Name | Kaiser Foundation Health Plan Of Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396810701 PECOS PAC ID: 9032022579 Enrollment ID: O20031112000454 |
| Mailing Address | Practice Location Address |
|---|---|
| Jane K Mellott, MD 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 Ph: (253) 596-3300 | Jane K Mellott, MD 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 Ph: (253) 596-3300 |
Alexander L Bowers, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 9040a Jackson Ave Joint Base Lewis-mcchord, Tacoma, WA 98431 Phone: 253-968-3066 | |
David Lee Robinson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-2252 | |
Nan Shin Moynihan, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1112 S Cushman Ave, Tacoma, WA 98405 Phone: 253-593-2144 Fax: 253-280-9881 | |
Arthur L Walter, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Pediatric Extended Care Clinic, Madigan Army Medical Center, Tacoma, WA 98431 Phone: 253-968-3066 | |
Bradley Stanton Hood, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 311 S L St, Tacoma, WA 98405 Phone: 253-403-1540 | |
Kirk N. Liesemer, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-3066 | |
Christopher Anthony Bellotti, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 603 S J St Ste 102, Tacoma, WA 98405 Phone: 253-396-4868 Fax: 253-396-4870 |