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General NPI Number Information
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NPI Number | 1528224920
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Entity Type | Individual
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Provider Name | MELISSA ELAINE LEWIS DPT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 2405 SE CENTURY BLVD #109
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City | HILLSBORO
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State | OR
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Zip | 97123-8294
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Country | US
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Telephone | 971-245-6845
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Fax | 971-249-3041
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Provider Business Mailing Address
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Address Line | 2405 SE CENTURY BLVD #109
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City | HILLSBORO
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State | OR
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Zip | 97123-8294
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Country | US
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Telephone | 971-245-6845
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Fax | 971-249-3041
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 60291
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License Number State | OR
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