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General NPI Number Information
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NPI Number | 1063177269
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Entity Type | Individual
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Provider Name | MELISSA A JONES CRM/PSS/QMHA-R
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Gender | Female
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 355 NW DIVISION ST
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City | GRESHAM
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State | OR
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Zip | 97030-5523
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Country | US
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Telephone | 503-231-2641
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Fax | 503-231-1654
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 503-224-1044
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Fax | 971-260-0355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | THW000105322
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 25-QMHA-R-7572
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21-CRM-470
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License Number State | OR
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