Healthcare Provider Details

I. General information

NPI: 1982534376
Provider Name (Legal Business Name): MELISSA DUECK ED.D., MPH, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5441 S MACADAM AVE STE R
PORTLAND OR
97239-3822
US

IV. Provider business mailing address

5441 MACADAM AVE STE R
PORTLAND OR
97239
US

V. Phone/Fax

Practice location:
  • Phone: 971-842-7284
  • Fax:
Mailing address:
  • Phone: 702-234-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number556372
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR9584
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: