Provider Demographics
NPI:1063471852
Name:MELLE, FRANCESCA T (PAC)
Entity Type:Individual
Prefix:MS
First Name:FRANCESCA
Middle Name:T
Last Name:MELLE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SW ARROW
Mailing Address - Street 2:
Mailing Address - City:WALDPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97394
Mailing Address - Country:US
Mailing Address - Phone:541-536-3197
Mailing Address - Fax:541-536-3198
Practice Address - Street 1:150 SW ARROW
Practice Address - Street 2:
Practice Address - City:WALDPORT
Practice Address - State:OR
Practice Address - Zip Code:97394
Practice Address - Country:US
Practice Address - Phone:541-536-3197
Practice Address - Fax:541-536-3198
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA169805363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50052712OtherCAPITAL BLUE CROSS
P28970Medicare UPIN
PA092123D6GMedicare ID - Type Unspecified