Organization
BARBARA S MALLETT,MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA S MALLETT M.D (OWNER)
(503) 654-5636
Entity
Organization
Contact information
Practice address
6542 SE LAKE RD, SUITE 202, MILWAUKIE, OR 97222-2244
(503) 654-5636
Mailing address
6542 SE LAKE RD, SUITE 202, MILWAUKIE, OR 97222-2244
(503) 654-5636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD17507
OR
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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