Healthcare Provider Details

I. General information

NPI: 1841501269
Provider Name (Legal Business Name): MELINDA LEE MEEKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 SW HALL BLVD
TIGARD OR
97223-6721
US

IV. Provider business mailing address

9250 SW HALL BLVD
TIGARD OR
97223-6721
US

V. Phone/Fax

Practice location:
  • Phone: 503-293-0161
  • Fax:
Mailing address:
  • Phone: 503-293-0161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201150062NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: