Provider Demographics
NPI:1447306352
Name:MCHALE, MELINDA KAY (LMT)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:KAY
Last Name:MCHALE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 OLD DUFUR RD
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-4040
Mailing Address - Country:US
Mailing Address - Phone:541-993-2878
Mailing Address - Fax:
Practice Address - Street 1:2636 OLD DUFUR RD
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-4040
Practice Address - Country:US
Practice Address - Phone:541-993-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10169225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty