Individual
MELODY FLANNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12442 SW SCHOLLS FERRY RD, SUITE 106, TIGARD, OR 97223-3396
(503) 216-9200
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA164077
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500660276
—
OR
Enumeration date
07/23/2013
Last updated
03/09/2021
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