Individual provider · Type 1 NPI

Melissa Koziol, PA-C

Surgical Physician Assistant · Portland, OR

NPI number 1811419682 Active

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098

Fax (503) 494-0294

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant Primary 363AS0400XPA191043 (OR)

Surgical Physician Assistant: Definition to come...

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About NPI 1811419682

Melissa Koziol, PA-C's National Provider Identifier is 1811419682, issued on Jul 12, 2017. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Portland, OR. The record was last updated on Jan 3, 2019.