Doctor Name: | MRS. MELANIE ANNE MELLIS |
NPI Number: | 1275678922 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 11662 |
Business Practice Address: | 18813 Willamette Dr West Linn, OR - 970681711 |
Business Phone Number: | 5036212058 |
Business Fax Number: | |
Mailing Address: | 18813 Willamette Dr, WEST LINN |
State: | OR |
Postal Code: | 970681711 |
Phone Number: | 5036212058 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 04/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 11662 |
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. |