Individual
DR. MICHAEL VINCENT MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8192 SW DURHAM RD, TIGARD, OR 97224-7315
(503) 257-5568
(503) 257-5566
Mailing address
8192 SW DURHAM RD, TIGARD, OR 97224-7315
(503) 257-5568
(503) 257-5566
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
DO21359
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134082
—
OR
Enumeration date
03/30/2007
Last updated
05/22/2008
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