Provider Demographics
NPI:1013146893
Name:MELZER, CHERYL DAWN (PT)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:DAWN
Last Name:MELZER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:DAWN
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31300 SW COUNTRY VIEW LANE
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070
Mailing Address - Country:US
Mailing Address - Phone:503-258-7340
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK ROAD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-494-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist