Individual
MRS. MELISA ANNE LAURITS-STOCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3550 N. INTERSTATE AVE., INTERSTATE MEDICAL OFFICE EAST, PORTLAND, OR 97227-1097
(503) 331-6440
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 331-6440
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 00917
OR
Other
Enumeration date
10/04/2006
Last updated
07/13/2010
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