Provider Demographics
NPI:1487847554
Name:CRITES-BACHERT, MELANIE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:ANN
Last Name:CRITES-BACHERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3269 N STOCKTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3619
Mailing Address - Country:US
Mailing Address - Phone:928-263-4722
Mailing Address - Fax:
Practice Address - Street 1:24076 SE STARK ST
Practice Address - Street 2:SUITE 310
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3373
Practice Address - Country:US
Practice Address - Phone:503-492-6510
Practice Address - Fax:503-492-6502
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO154071208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology