Individual
MELANIE RUTH BISSONNETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8532 N IVANHOE ST, SUITE 201, PORTLAND, OR 97203-4827
(503) 267-0853
Mailing address
8532 N IVANHOE ST, SUITE 201, PORTLAND, OR 97203-4827
(503) 267-0853
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11999
OR
Other
Enumeration date
08/02/2007
Last updated
01/23/2016
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