Melissa Maureen Leak, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4005 Issued in OR

Practice address

1601 E Fourth Plain Blvd
Vancouver, WA 98661-3753

Phone

(360) 696-4061

NPI assigned

Jan 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Melissa Maureen Lathrop Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1841476033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 SE ASPEN SUMMIT DR",
            "address_2": "APT. #60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666155",
            "telephone_number": "770-543-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613753",
            "telephone_number": "360-696-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAK",
        "first_name": "MELISSA",
        "middle_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009183",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LATHROP",
            "middle_name": "MAUREEN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thi Le
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• Troy A Leaf, MA60765114
• Bret William League, LPN
• Nathaniel Brandon Leahy, LAC.
• Alma Leal
• Jaqueline Leanos Alvarez
• Heather Leap, MSW
• Megan Learing, MASSAGE THERAPIST
• Alyssa Marie Leary, LMP

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.