MEDICARE: DR. VIVIENNE TERESA MELJEN M.D.

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	207V00000X	Obstetrics & Gynecology Physician	MD223920	OR
2	207V00000X	Obstetrics & Gynecology Physician	MD61131512	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801328653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIVIENNE TERESA MELJEN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14508 NE 20TH AVE
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98686-6424
Country	:	US
Telephone Number	:	360-892-0208
Fax Number	:	360-892-9081

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

Provider Enumeration Date	:	03/31/2017
Last Update Date	:	08/18/2025

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