Healthcare Provider Details

I. General information

NPI: 1972631166
Provider Name (Legal Business Name): SHERI LYNN MASESSA OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 MIRA MAR AVE
MEDFORD OR
97504-5520
US

IV. Provider business mailing address

10133 SHERRILL BLVD STE 200
KNOXVILLE TN
37932-3347
US

V. Phone/Fax

Practice location:
  • Phone: 888-532-2204
  • Fax:
Mailing address:
  • Phone: 888-532-2204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1013205
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: