Organization
360 PELVIC HEALTH INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE ANN CRITES BACHERT DO (FOUNDER AND PRESIDENT)
(503) 492-6510
Entity
Organization
Contact information
Practice address
24076 SE STARK ST, SUITE 310, GRESHAM, OR 97030
(503) 492-6510
Mailing address
24076 SE STARK ST, SUITE 310, GRESHAM, OR 97030
(503) 492-6510
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
208800000X
Urology Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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