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NPI Code Detail

MEDICARE: MADELYN DORRELL LMT, CA

MEDICARE: MADELYN DORRELL LMT, CA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health WorkerLMT-23591OR

General Provider Information

NPI Number : 1003448168
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELYN DORRELL LMT, CA
Provider Business Mailing Address
First Line : 16679 BOONES FERRY RD STE 105
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-4378
Country : US
Telephone Number : 503-635-6005
Fax Number : 503-635-6016
Provider Business Practice Location Address
First Line : 16679 BOONES FERRY RD STE 105
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-4378
Country : US
Telephone Number : 503-635-6005
Fax Number : 503-635-6016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2020
Last Update Date : 11/12/2025

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Directions to “ MADELYN DORRELL LMT, CA” Practice Location

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