Individual
MISS MELODY GRACE TONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2124 BABBITT CT, FOREST GROVE, OR 97116-2955
(503) 380-6724
Mailing address
2124 BABBITT CT, FOREST GROVE, OR 97116-2955
(503) 380-6724
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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