=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194158212
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MERCEDES E. MEE RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2013
-----------------------------------------------------
Last Update Date | 08/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7320 SW HUNZIKER ST SUITE 203
-----------------------------------------------------
City | TIGARD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97223-8283
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-317-1019
-----------------------------------------------------
Fax | 888-317-1020
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5880 SE SNOWBERRY CT
-----------------------------------------------------
City | HILLSBORO
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97123-6599
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-746-5004
-----------------------------------------------------
Fax | 503-746-5004
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN60118846
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 200742782RN
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------