Provider Demographics
NPI:1851514343
Name:VESSELY, MICHELLE BLEYNAT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BLEYNAT
Last Name:VESSELY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6485 SW BORLAND RD STE C
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9762
Mailing Address - Country:US
Mailing Address - Phone:503-692-1190
Mailing Address - Fax:503-692-7017
Practice Address - Street 1:6485 SW BORLAND RD STE B
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9762
Practice Address - Country:US
Practice Address - Phone:503-692-1190
Practice Address - Fax:503-692-7017
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34786207YX0007X
ORMD18645207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck