Healthcare Provider Details

I. General information

NPI: 1922192764
Provider Name (Legal Business Name): NARDA MELISSA SHERMAN P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N GRAHAM ST SUITE 555
PORTLAND OR
97227-1654
US

IV. Provider business mailing address

16420 SE DIVISION STREET PORTLAND METRO TREATMENT CENTER
PORTLAND OR
97236-1987
US

V. Phone/Fax

Practice location:
  • Phone: 503-288-7535
  • Fax: 503-288-7538
Mailing address:
  • Phone: 503-762-3130
  • Fax: 503-288-7538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number212895
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA00799
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: