Individual
MELISSA KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(707) 535-9806
Mailing address
4144 MAIN ST, SHASTA LAKE, CA 96019-9642
(707) 535-9806
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
P160362934
WA
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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