Healthcare Provider Details

I. General information

NPI: 1700049152
Provider Name (Legal Business Name): EILEEN MELODY CLEVELAND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 SW PACIFIC HWY STE H3013
TIGARD OR
97224-4053
US

IV. Provider business mailing address

16200 SW PACIFIC HWY STE H3013
TIGARD OR
97224-4053
US

V. Phone/Fax

Practice location:
  • Phone: 541-240-3071
  • Fax: 541-241-8031
Mailing address:
  • Phone: 541-241-3071
  • Fax: 541-241-8031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201708443NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: