Individual
MELODY E KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9125 SW 55TH AVE, PORTLAND, OR 97219-5018
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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