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1083142616

NPI Code Detail

MEDICARE: JONATHAN SCOTT MELGAR D.O.

MEDICARE: JONATHAN SCOTT MELGAR D.O.

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
1	207R00000X	Internal Medicine Physician	2019-00906	NC
2	208M00000X	Hospitalist Physician	DO2759	NV
3	207R00000X	Internal Medicine Physician	OP61503041	WA
4	208M00000X	Hospitalist Physician	2019-00906	NC
5	208M00000X	Hospitalist Physician	DO.OP.61503041	WA
6	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1083142616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN SCOTT MELGAR D.O.

Provider Business Mailing Address
First Line	:	939 CAROLINE STREET
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-3909
Country	:	US
Telephone Number	:	360-565-9237
Fax Number	:

Provider Business Practice Location Address
First Line	:	939 CAROLINE ST
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-3909
Country	:	US
Telephone Number	:	360-417-7000
Fax Number	:	360-417-7318

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2017
Last Update Date	:	02/03/2026

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Directions to “ JONATHAN SCOTT MELGAR D.O.” Practice Location

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