Healthcare Provider Details

I. General information

NPI: 1831634641
Provider Name (Legal Business Name): PETER MEILAHN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 CLUB RD STE 200
EUGENE OR
97401-2460
US

IV. Provider business mailing address

2355 STATE ST STE 101
SALEM OR
97301-4541
US

V. Phone/Fax

Practice location:
  • Phone: 541-393-5983
  • Fax:
Mailing address:
  • Phone: 651-347-8172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC9007
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: