Provider Demographics
NPI:1467511386
Name:SHAYS, MELISSA A (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:SHAYS
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:MOSIER
Mailing Address - State:OR
Mailing Address - Zip Code:97040-0324
Mailing Address - Country:US
Mailing Address - Phone:888-386-8784
Mailing Address - Fax:866-850-9552
Practice Address - Street 1:2002 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9543
Practice Address - Country:US
Practice Address - Phone:503-750-5277
Practice Address - Fax:866-850-9552
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC802171100000X
OR1343175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR20-5794790Medicare UPIN