Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 34786 | NC |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | MD18645 | OR |
NPI | 1851514343 |
---|---|
Provider Name | Dr. Michelle Bleynat Vessely |
First Address | Tualatin, OR 97062-9762 |
Second Address | Tualatin, OR 97062-9762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 28/04/2021 |