Individual
RICCO FRANK MEJIA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1817 NE 6TH AVE, PORTLAND, OR 97212-3960
(503) 719-7985
Mailing address
1817 NE 6TH AVE, PORTLAND, OR 97212-3960
(503) 719-7985
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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