Melissa Brackle
Individual provider Active NPI Occupational Therapy Assistant · Wilsonville, OR
NPI 1780075853 · NPPES record last updated Feb 11, 2015
Key facts
- NPI
- 1780075853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 771 (NE)
- Practice address
- 25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697 - Phone
- (913) 961-8451
- NPI assigned
- Feb 11, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 771 | NE | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 771 | NE | Yes |
Addresses
Primary practice location
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Mailing address
1430 Watson St
Fremont, NE 68025-2084
Other providers in Wilsonville, OR
- Sara Denise Bourdon
- Jasyn-Christy Ann Bourne
- Ann Mariko Bouse
- Annika Bowlsby McBride
- Melissa Boyd
- Alexandra Braun
- Ryan Bridges
- Brittany Samantha Brockman
- Brookdale Hospice, LLC
- Brittney Brookfield
All providers in Wilsonville, OR · Occupational Therapy Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.