Active NPI
Metamorphosis Mental Health, LLC
- Psychiatric/Mental Health Nurse Practitioner
- Medford, OR
National Provider Identifier
1114849023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- METAMORPHOSIS MENTAL HEALTH, LLC
- Practice address
- 412 Hawk Rd
Medford, OR 97501-8556 - Phone
- (541) 517-1111
- NPI assigned
- Jul 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brittany Wall, PMHNP
- Title
- Owner
- Phone
- (541) 517-1111
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
412 Hawk Rd
Medford, OR 97501-8556
Mailing address
5441 S Macadam Ave Ste N
Portland, OR 97239-3822
Other practice location 1
809 E Jackson St
Medford, OR 97504-6713
Phone (541) 245-3614
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Medford, OR
- NPI 1659239838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785369600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785369600000",
"number": "1114849023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5441 S MACADAM AVE STE N",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 HAWK RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975018556",
"telephone_number": "541-517-1111"
}
],
"practiceLocations": [
{
"address_1": "809 E Jackson St",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975046713",
"country_code": "US",
"telephone_number": "541-245-3614",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "METAMORPHOSIS MENTAL HEALTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-30",
"last_updated": "2026-07-30",
"certification_date": "2026-07-29",
"status": "A",
"authorized_official_last_name": "WALL",
"authorized_official_first_name": "BRITTANY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "541-517-1111",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.