MEDICARE: MELISSA RENEE BARWIG LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	16044	OR

General Provider Information

NPI Number	:	1023327533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA RENEE BARWIG LMT

Provider Business Mailing Address
First Line	:	3285 COLSON CT SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-3381
Country	:	US
Telephone Number	:	503-409-4765
Fax Number	:

Provider Business Practice Location Address
First Line	:	4555 LIBERTY RD S STE 220
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-5093
Country	:	US
Telephone Number	:	503-877-3529
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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