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Organization
MELISSA MERCOGLIANO, PT, PS
Active
Organization
MELISSA MERCOGLIANO, PT, PS
Active
Other names
Center for Orthopedic & Lymphatic Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA AUTHIER MERCOGLIANO PT, DPT, OCS (PRESIDENT)
(360) 874-0745
Entity
Organization
Contact information
Practice address
463 TREMONT STREET WEST, STE 100, PORT ORCHARD, WA 98366
(360) 874-0745
(360) 874-0846
Mailing address
463 TREMONT STREET WEST, STE 100, PORT ORCHARD, WA 98366
(360) 874-0745
(360) 874-0846
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003857
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137035
LABOR AND INDUSTRIES WA
WA
01
—
472217001
ALLIANCE
WA
01
—
5214359
AETNA
—
01
—
5414ME
REGENCE
WA
Enumeration date
10/02/2006
Last updated
07/03/2020
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