Individual ProviderMelissa Jo MiesenAcupuncturistOther Service ProvidersPractice Address1706 NW Glisan St, Ste 5, Portland, OR 97209-2225(503) 228-5000(503) 238-8821PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Jo Miesen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 5:04 PM.Profile DetailsProvider ID1639118540Provider TypeIndividualFull NameMiesen, Melissa JoCredentialL AC., LMT.GenderFemaleEnumeration Date6/6/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1706 NW Glisan St, Ste 5, Portland, OR 97209-2225Phone(503) 228-5000Fax(503) 228-5019Mailing LocationMailing Address4901 SW Fairhaven Dr, Portland, OR 97221-2617Phone(503) 238-8821Fax(503) 228-5019Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicenseAC00695Oregon