Provider Demographics
NPI:1508157744
Name:ORR, MELISSA MARIANNE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MARIANNE
Last Name:ORR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:MARIANNE
Other - Last Name:MANSFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44-2685 KALANIAI RD.
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727
Mailing Address - Country:US
Mailing Address - Phone:808-775-7773
Mailing Address - Fax:360-944-3925
Practice Address - Street 1:65-1206 MAMALAHOA HWY
Practice Address - Street 2:BLDG 3 UNIT 10
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-775-7773
Practice Address - Fax:360-944-3925
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60211559225700000X
HI14847225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist