MEDICARE: DR. MELISSA ANNE BARTOSZEWSKI D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		NY
2	111N00000X	Chiropractor	5660	OR
3	111N00000X	Chiropractor	12368	TX
4	111N00000X	Chiropractor	4258	NC

General Provider Information

NPI Number	:	1174896724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA ANNE BARTOSZEWSKI D.C

Provider Business Mailing Address
First Line	:	7232 N BURLINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-4817
Country	:	US
Telephone Number	:	503-893-8336
Fax Number	:

Provider Business Practice Location Address
First Line	:	7232 N BURLINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-4817
Country	:	US
Telephone Number	:	503-893-8336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2012
Last Update Date	:	06/30/2020

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