MEDICARE: MELANIE MELES GEBREMARIAM

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	320800000X	Mental Illness Community Based Residential Treatment Facility		OR

General Provider Information

NPI Number	:	1528997723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MELES GEBREMARIAM

Provider Business Mailing Address
First Line	:	14414 SE TOPAZ AVE
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97267-2231
Country	:	US
Telephone Number	:	619-657-6527
Fax Number	:

Provider Business Practice Location Address
First Line	:	14414 SE TOPAZ AVE
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97267-2231
Country	:	US
Telephone Number	:	619-657-6527
Fax Number	:

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

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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Directions to “ MELANIE MELES GEBREMARIAM ” Practice Location

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