Individual
MICHELLE MEADOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 SW 6TH CT, GRESHAM, OR 97080-9390
(503) 260-6907
Mailing address
124 SW 6TH CT, GRESHAM, OR 97080-9390
(503) 260-6907
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
241470
OR
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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