Individual
MELISSA MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2570 NW EDENBOWER BLVD, #100, ROSEBURG, OR 97471
(541) 677-7200
(541) 229-3309
Mailing address
2570 NW EDENBOWER BLVD, #100, ROSEBURG, OR 97471
(541) 677-7200
(541) 229-3309
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
85002846
IL
363AM0700X
Medical Physician Assistant
Primary
PA03176
OR
Other
Enumeration date
10/13/2006
Last updated
09/08/2008
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