Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
N | 225100000X | Physical Therapist | 3932 | OR |
N | 225100000X | Physical Therapist | PT00008184 | WA |
N | 2251X0800X | Physical Therapist - Orthopedic | ||
Y | 2251X0800X | Physical Therapist - Orthopedic | 03932 | OR |
NPI | 1083802409 |
---|---|
Provider Name | Mrs. Melanie Andrea Embree |
First Address | Bend, OR 97702 |
Second Address | Bend, OR 97702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 30/01/2017 |