Individual
DR. MELISSA BETH BUBOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, UHN 80, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
5156 SW MULTNOMAH BLVD, UNIT K, PORTLAND, OR 97219-3372
(503) 977-7903
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD26388
OR
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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