Healthcare Provider Details

I. General information

NPI: 1730874694
Provider Name (Legal Business Name): MELODY SANCHEZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELODY KARSCHNIA PTA

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 N 1ST ST STE D
HERMISTON OR
97838-1682
US

IV. Provider business mailing address

PO BOX 540640
NORTH SALT LAKE UT
84054-0640
US

V. Phone/Fax

Practice location:
  • Phone: 541-567-5678
  • Fax: 541-567-2110
Mailing address:
  • Phone: 801-987-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8161
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: