Individual
MICHELLE CECILE CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
24850 SE STARK ST, SUITE 200, GRESHAM, OR 97030-8316
(503) 491-9444
(503) 661-1420
Mailing address
24850 SE STARK ST, SUITE 200, GRESHAM, OR 97030-8316
(503) 491-9444
(503) 661-1420
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
081046795N5 NMNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212851
—
OR
Enumeration date
08/04/2006
Last updated
01/26/2012
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