Individual
MELISSA J SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-2392
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
201341076RN
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
202108974NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
202108974NP-PP
OR
Other
Enumeration date
10/21/2015
Last updated
01/22/2024
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