Individual
AMANDA MELBOSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 SW TAYLOR ST STE 200, PORTLAND, OR 97204-2446
(503) 446-2500
Mailing address
3760 SE MORRISON ST, PORTLAND, OR 97214-3210
(636) 399-0736
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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