Provider Demographics
NPI:1689014649
Name:SANDLEY, MELISSA ANN (PHARMD, BCPPS)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:SANDLEY
Suffix:
Gender:F
Credentials:PHARMD, BCPPS
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:REES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCPPS
Mailing Address - Street 1:7465 SW 80TH TER
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-7535
Mailing Address - Country:US
Mailing Address - Phone:585-233-0504
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-04
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021396183500000X
CARPH72274183500000X
WAPH 60292316183500000X
ORRPH-0018757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist