Mabelle Chan Mendoza

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62768 Issued in OR

Practice address

2345 Biehn St
Klamath Falls, OR 97601-1761

Phone

(541) 882-4612

Fax

(541) 273-2908

NPI assigned

May 29, 2018

Last updated

May 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Health & Wellness, LLC

  • Acupuncturist
  • Klamath Falls, OR
  • NPI 1740313410

  Physical Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1588155246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 BIEHN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011761",
            "telephone_number": "541-882-4612",
            "fax_number": "541-273-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 BIEHN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011761",
            "telephone_number": "541-882-4612",
            "fax_number": "541-273-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MABELLE",
        "middle_name": "CHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OREGON PHYSICAL THERAPIST LICENSING BOARD",
            "identifier": "62768",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Melland, DDS
• Levi Meltabarger
• Robert Thomas Melton, MD
• Kendall A Membreno
• Jonathan Ace Cezo Mendoza
• Shreya Lynn Menges
• George Craig Merhoff Sr.
• Merle West Hematology Oncology Physicians
• Merle West Medical Center Inc Dba (West Occupational Care Clinic)
• Lori Merriam

• Physical Therapist in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.