Mesa, Michael Vincent

Mesa, Michael Vincent is an sole proprietor health care provider with primary practice located at 8192 Sw Durham Rd , Tigard OR 97224-7315. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Mesa, Michael Vincent can be contacted via phone (503) 257-5568.

Contact Information

Primary practice address
8192 Sw Durham Rd Tigard OR 97224-7315
Fax: (503) 257-5566
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X DO21359 Oregon

Profile Details

NPI number 1184744351
LBN Legal business name Mesa, Michael Vincent
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 30th, 2007
Last updated May 22nd, 2008 - about 18 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 1184744351 NPPES
Oregon MEDICAID 134082

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