Provider Demographics
NPI:1104274778
Name:BARTLETT, MELISSA A (DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 NE BAKER ST STE 140
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4907
Mailing Address - Country:US
Mailing Address - Phone:503-472-0848
Mailing Address - Fax:503-435-1930
Practice Address - Street 1:609 NE BAKER ST STE 140
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4907
Practice Address - Country:US
Practice Address - Phone:503-472-0848
Practice Address - Fax:503-435-1930
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT61647225100000X
OR61647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist