Doctor Name: | MRS. MELINDA GRACE APODACA |
NPI Number: | 1053359521 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT #11539 |
License Number: | 11539 |
Business Practice Address: | 1922 21st Ave. Forest Grove, OR - 97116 |
Business Phone Number: | 5036823811 |
Business Fax Number: | 5036820416 |
Mailing Address: | 1922 21st Ave., FOREST GROVE |
State: | OR |
Postal Code: | 97116 |
Phone Number: | 5037017714 |
Fax Number: | 5037470556 |
NPI Enumeration Date: | 06/04/2006 |
NPI Last Update Date: | 07/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 11539 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |