Healthcare Provider Details

I. General information

NPI: 1033910955
Provider Name (Legal Business Name): JOSEF MENDELSOHN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NE HOOD AVE STE 310
GRESHAM OR
97030-7324
US

IV. Provider business mailing address

501 NE HOOD AVE STE 310
GRESHAM OR
97030-7324
US

V. Phone/Fax

Practice location:
  • Phone: 503-208-5288
  • Fax:
Mailing address:
  • Phone: 978-319-5987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: