Provider Demographics
NPI:1316607633
Name:HUGHES, MELISSA IRENE (ND)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:IRENE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 SE SALMON ST APT C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-2468
Mailing Address - Country:US
Mailing Address - Phone:520-440-9508
Mailing Address - Fax:
Practice Address - Street 1:555 SE M L KING BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2120
Practice Address - Country:US
Practice Address - Phone:520-440-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4439175F00000X
OR175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath