Healthcare Provider Details

I. General information

NPI: 1255421780
Provider Name (Legal Business Name): MELISSA SUE FIVECOAT LPC, CADC III, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA SUE FIVECOAT MELISSA FIVECOAT-BOR

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 NE TANASBOURNE DR
HILLSBORO OR
97124-7836
US

IV. Provider business mailing address

10315 NE TANASBOURNE DR
HILLSBORO OR
97124-7836
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone: 800-813-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC1959
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: