Melissa Beth Buboltz | Portland, OR • PECOS Search

Melissa Beth Buboltz

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Uhn 80, Portland, OR 97239-3011

(503) 494-8311 (503) 977-7903

PECOS Enrollment

Based on the most recent information from CMS, provider Melissa Beth Buboltz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1003995945
Provider Type
Individual
Full Name
Buboltz, Melissa Beth
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
11/2/2006
Last Updated
7/8/2007

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Uhn 80, Portland, OR 97239-3011

Unlisted Fax

Mailing Location

5156 SW Multnomah Blvd, Unit K, Portland, OR 97219-3372

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD26388 Oregon