Healthcare Provider Details

I. General information

NPI: 1275338600
Provider Name (Legal Business Name): LIZBETH MEZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 SE OAK ST # C
HILLSBORO OR
97123-4392
US

IV. Provider business mailing address

265 SE OAK ST # C
HILLSBORO OR
97123-4392
US

V. Phone/Fax

Practice location:
  • Phone: 971-441-0460
  • Fax:
Mailing address:
  • Phone: 971-441-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: