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General NPI Number Information
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NPI Number | 1578099941
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Entity Type | Individual
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Provider Name | RAHUL JOSEPH D'MELLO MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD ML-466
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City | PORTLAND
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State | OR
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Zip | 97239-3098
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Country | US
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Telephone | 503-418-4500
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Fax | 503-494-1678
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD ML-466
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 971-254-7664
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD203797
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD61275846
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD203797
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License Number State | OR
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