Mellick, Laura

Mellick, Laura is an individual health care provider with primary practice located at 25 Nw 23Rd Pl Suite 11, Portland OR 97210-5580. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Mellick, Laura can be contacted via phone (503) 305-6262.

Contact Information

Primary practice address
25 Nw 23Rd Pl Suite 11 Portland OR 97210-5580
Phone: (503) 305-6262
Fax: (503) 305-6078
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD17993 Oregon
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD17993 Oregon

Profile Details

NPI number 1851354872
LBN Legal business name Mellick, Laura
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Sep 6th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851354872 NPPES
Other 208975 WA L & I
MEDICAID 057252 WA L & I
Other 858543007 WA L & I
MEDICAID 8182214 WA L & I

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