MEDICARE: DR. MELINDA NICKELS N.D., L.AC.

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	171100000X	Acupuncturist	AC01291	OR
2	175F00000X	Naturopath	NT60051160	WA
3	175F00000X	Naturopath	1669	OR

General Provider Information

NPI Number	:	1093960080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELINDA NICKELS N.D., L.AC.

Provider Business Mailing Address
First Line	:	10 PIER 1 STE 308
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-6338
Country	:	US
Telephone Number	:	503-974-0914
Fax Number	:	888-972-3725

Provider Business Practice Location Address
First Line	:	10 PIER 1 STE 308
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-6338
Country	:	US
Telephone Number	:	503-974-0914
Fax Number	:

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

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	03/28/2025

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Directions to “ DR. MELINDA NICKELS N.D., L.AC.” Practice Location

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