Provider Demographics
NPI:1053898262
Name:FRAZIER, MELISSA ANGELA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANGELA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANGELA
Other - Last Name:QUERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2710 E 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6678
Mailing Address - Country:US
Mailing Address - Phone:509-252-2354
Mailing Address - Fax:509-252-2357
Practice Address - Street 1:2710 E 57TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-6678
Practice Address - Country:US
Practice Address - Phone:509-252-2354
Practice Address - Fax:509-252-2357
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-007524225X00000X
WAOT61301081225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist