Individual
MRS. MELISSA KAY COLASURDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10535 NE GLISAN ST, PORTLAND, OR 97220-4077
(503) 444-8181
Mailing address
4406 SW DONNER WAY, PORTLAND, OR 97239-1540
(503) 385-6606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10105
OR
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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