MELANIE GRACE MIX

PORTLAND, OR
NPI1922588508
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: OR  PA186897)
Enumeration Date2018-08-14
Last Update Date2023-12-05
Business Address
MELANIE GRACE MIX PAC
501 N GRAHAM ST STE 420
PORTLAND, OR 97227
Phone number: 503-288-7303
Mailing Address
MELANIE GRACE MIX PAC
541 NE 20TH AVE STE 225
PORTLAND, OR 97232-2895
Phone number: 503-963-2801