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NPI Code Detail

MEDICARE: MELANIE B MAMOLA PROF.COUNSELOR ASS.

MEDICARE: MELANIE B MAMOLA PROF.COUNSELOR ASS.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOR
2101YP2500XProfessional CounselorR7605OR

General Provider Information

NPI Number : 1891749941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE B MAMOLA PROF.COUNSELOR ASS.
Provider Business Mailing Address
First Line : 9670 SW BEAVERTON HILLSDALE HWY
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-3307
Country : US
Telephone Number : 971-229-4009
Fax Number : 866-324-6009
Provider Business Practice Location Address
First Line : 9670 SW BEAVERTON HILLSDALE HWY
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-3307
Country : US
Telephone Number : 971-229-4009
Fax Number : 866-324-6009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 08/25/2025

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