Individual
DR. MISCHELLE MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
24988 SE STARK ST, #220, GRESHAM, OR 97030-8322
(503) 674-1580
(503) 674-1581
Mailing address
24988 SE STARK ST., #220, GRESHAM, OR 97030
(503) 674-1580
(503) 674-1581
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19769
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081682
—
OR
Enumeration date
11/08/2006
Last updated
03/17/2017
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