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Individual

MELINDA R MULLIGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
(503) 570-3665
Mailing address
4125 NE 109TH AVE, PORTLAND, OR 97220-2614
(503) 481-3900

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
00004580
WA
225X00000X
Occupational Therapist
Primary
1042879
OR

Other

Enumeration date
08/03/2010
Last updated
08/03/2010
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