Provider Demographics
NPI:1750561163
Name:ARZABAL, MELISSA A (BSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:ARZABAL
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11456 NE KNOTT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-1706
Mailing Address - Country:US
Mailing Address - Phone:503-736-6504
Mailing Address - Fax:503-256-9601
Practice Address - Street 1:11456 NE KNOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-1706
Practice Address - Country:US
Practice Address - Phone:503-736-6504
Practice Address - Fax:503-256-9601
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker