Healthcare Provider Details

I. General information

NPI: 1033870407
Provider Name (Legal Business Name): MELANIE KING VELEZ DNP PMHNP BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 CENTENNIAL BLVD STE 12
SPRINGFIELD OR
97477-3378
US

IV. Provider business mailing address

2178 KIMBERLY CIR
EUGENE OR
97405-5820
US

V. Phone/Fax

Practice location:
  • Phone: 541-237-1522
  • Fax: 541-722-7332
Mailing address:
  • Phone: 541-237-1522
  • Fax: 541-722-7332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number202200050NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: