Healthcare Provider Details

I. General information

NPI: 1659294437
Provider Name (Legal Business Name): MELISSA SPIVEY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3523 HIGHWAY 101 N
SEASIDE OR
97138-4319
US

IV. Provider business mailing address

PO BOX 1175
WARRENTON OR
97146-1175
US

V. Phone/Fax

Practice location:
  • Phone: 971-445-6140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number17233
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: