Healthcare Provider Details

I. General information

NPI: 1194158212
Provider Name (Legal Business Name): MERCEDES E. MEE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 SW HUNZIKER ST SUITE 203
TIGARD OR
97223-8283
US

IV. Provider business mailing address

5880 SE SNOWBERRY CT
HILLSBORO OR
97123-6599
US

V. Phone/Fax

Practice location:
  • Phone: 888-317-1019
  • Fax: 888-317-1020
Mailing address:
  • Phone: 503-746-5004
  • Fax: 503-746-5004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60118846
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number200742782RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: