Individual
MELISSA KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37640 GREEN MOUNTAIN ST, SANDY, OR 97055-6366
(503) 502-1295
Mailing address
37640 GREEN MOUNTAIN ST, SANDY, OR 97055-6366
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016211
WA
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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