Healthcare Provider Details

I. General information

NPI: 1023930468
Provider Name (Legal Business Name): MILO MELVILLE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 NW 12TH AVE APT 412
PORTLAND OR
97209-2668
US

IV. Provider business mailing address

100 N HOWARD ST STE R
SPOKANE WA
99201-0508
US

V. Phone/Fax

Practice location:
  • Phone: 509-903-5597
  • Fax:
Mailing address:
  • Phone: 509-903-5597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY MELVILLE ORR
Title or Position: OWNER
Credential: LMHC
Phone: 509-903-5597