Individual
MS. MELISSA R. THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10024 SE 32ND AVE, MILWAUKIE, OR 97222-6514
(503) 659-4988
(503) 654-5666
Mailing address
PO BOX 22075, MILWAUKIE, OR 97269-2075
(503) 659-4777
(503) 652-5223
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00815
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077599
—
OR
01
—
970025914
RR MEDICARE
OR
Enumeration date
12/01/2005
Last updated
08/02/2010
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