Individual provider Active NPI

Mandelynn Grace Ann Pray, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • The Dalles, OR
National Provider Identifier
1124346994
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201050099NP Issued in OR
Practice address
1810 E 19TH St
Suite 209
The Dalles, OR 97058-3388
Phone
(541) 296-5657
Fax
(541) 298-5199
NPI assigned
May 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201050099NP OR Primary
Advanced Practice Midwife 367A00000X AWARDED JUNE 2010 OR

Addresses

Primary practice location

1810 E 19TH St
Suite 209
The Dalles, OR 97058-3388

Mailing address

1060 Webber St
The Dalles, OR 97058-3749
Phone (541) 296-5452

Other practice location 1

1060 Webber St
The Dalles, OR 97058-3749
Phone (541) 296-5452

Other identifiers 1

IdentifierTypeStateIssuer
500624408MedicaidOR

Other names 1

  • Mandelynn Grace Ann Morgan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101103001055 OR Practitioner - Certified Nurse Midwife (CNM) 2264626241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
201050099NPORMDPsychiatric/Mental Health Nurse Practitioner
AWARDED JUNE 2010ORMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Center for Living CurrentSince Sep 3, 2025 Accepting new patients
Mid-Columbia Medical Center CurrentSince Sep 4, 2013 Accepting new patients
Mid-Columbia Medical Center CurrentSince Sep 4, 2013 Accepting new patients
Mid-Columbia Center for Living CurrentSince Sep 3, 2025 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Mid-Columbia Center for Living PastSince Aug 20, 2026 Accepting new patients

Locations

1610 Woods Ct
Hood River, OR 97031
Phone (541) 386-2620

1810 E 19th St
Ste 209
The Dalles, OR 97058
Phone (541) 296-5657

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1060 Webber St
The Dalles, OR 97058

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1124346994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 WEBBER ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583749",
            "telephone_number": "541-296-5452",
            "fax_number": "541-296-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 E 19TH ST",
            "address_2": "SUITE 209",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583388",
            "telephone_number": "541-296-5657",
            "fax_number": "541-298-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 Webber St",
            "address_purpose": "LOCATION",
            "city": "The Dalles",
            "state": "OR",
            "postal_code": "970583749",
            "country_code": "US",
            "telephone_number": "541-296-5452",
            "fax_number": "541-296-5263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRAY",
        "first_name": "MANDELYNN",
        "middle_name": "GRACE ANN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201050099NP",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "AWARDED JUNE 2010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500624408",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDELYNN",
            "last_name": "MORGAN",
            "middle_name": "GRACE ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.