MEDICARE: DR. MELISSA RAE KINDER MD

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	208200000X	Plastic Surgery Physician	MD161983	OR
2	208200000X	Plastic Surgery Physician	35097074	OH
3	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	MD161983	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730346289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA RAE KINDER MD

Provider Business Mailing Address
First Line	:	10121 SE SUNNYSIDE RD
Second Line	:	SUITE 235
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-5754
Country	:	US
Telephone Number	:	503-498-8190
Fax Number	:	503-305-7425

Provider Business Practice Location Address
First Line	:	10121 SE SUNNYSIDE RD
Second Line	:	SUITE 235
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-5754
Country	:	US
Telephone Number	:	503-498-8190
Fax Number	:	503-305-7425

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

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	04/22/2021

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Directions to “ DR. MELISSA RAE KINDER MD” Practice Location

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