MEDICARE: EMILY MEROLLIS CONSULTING LLC

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	2251X0800X	Orthopedic Physical Therapist
2	225XP0019X	Physical Rehabilitation Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1265862353	OTHER		OT NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316409220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMILY MEROLLIS CONSULTING LLC

Provider Business Mailing Address
First Line	:	11 NE MARTIN LUTHER KING JR BLVD STE 202
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-3579
Country	:	US
Telephone Number	:	971-337-6372
Fax Number	:	503-594-1222

Provider Business Practice Location Address
First Line	:	11 NE MARTIN LUTHER KING JR BLVD STE 202
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-3579
Country	:	US
Telephone Number	:	971-337-6372
Fax Number	:	503-594-1222

Authorized Official
Title or Position	:	OWNER/OCCUPATIONAL THERAPIST
Name	:	EMILY L MEROLLIS
Credential	:
Telephone Number	:	971-337-6372

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	06/30/2023

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Directions to “EMILY MEROLLIS CONSULTING LLC ” Practice Location

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