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Individual

MS. MELISSA KATHRYN MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
2525 NE 139TH ST, VANCOUVER, WA 98686-2719
(360) 397-3870
(360) 397-3858
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 397-1500
(360) 397-3128

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP30007582
WA
367A00000X
Advanced Practice Midwife
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269690
OR
05
9651506
WA
Enumeration date
07/10/2006
Last updated
02/26/2008
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