Individual
MS. MELISSA KERI LYNNE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(503) 228-6479
Mailing address
6108 SW 18TH DR APT 6, PORTLAND, OR 97239-1951
(503) 452-3734
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
218510
OR
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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