Healthcare Provider Details

I. General information

NPI: 1871841056
Provider Name (Legal Business Name): MELISSA LOUDON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6143 BRASSIE WAY
REDDING CA
96003-8004
US

IV. Provider business mailing address

6143 BRASSIE WAY
REDDING CA
96003-8004
US

V. Phone/Fax

Practice location:
  • Phone: 503-453-9999
  • Fax:
Mailing address:
  • Phone: 503-453-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number17043
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: