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General NPI Number Information
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NPI Number | 1821054024
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Entity Type | Individual
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Provider Name | MELISSA LYN KILIAN FNP
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Gender | Female
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 4400 NE HALSEY ST STE 102
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City | PORTLAND
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State | OR
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Zip | 97213-1545
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Country | US
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Telephone | 503-962-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 NE HALSEY ST STE 102
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City | PORTLAND
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State | OR
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Zip | 97213-1545
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Country | US
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Telephone | 503-962-1000
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F334032-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9378277
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 54628
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 54628
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10945
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 202006390NP-PP
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License Number State | OR
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