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NPI Code Detail

MEDICARE: THOMAS MELVILLE

MEDICARE: THOMAS MELVILLE
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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15163OTHERORLICENSE

General Provider Information

NPI Number : 1083724777
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS MELVILLE
Provider Business Mailing Address
First Line : 3355 SE WASHINGTON ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-3138
Country : US
Telephone Number : 201-669-8980
Fax Number :
Provider Business Practice Location Address
First Line : 2330 NW FLANDERS ST STE 101
Second Line :
City : PORTLAND
State : OR
Zip : 97210-3400
Country : US
Telephone Number : 503-288-8578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ THOMAS MELVILLE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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