Melissa Brook Mendez

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

201011830CNA Issued in OR

Practice address

19300 SW 65TH Ave
Tualatin, OR 97062-7706

Phone

(503) 692-1212

NPI assigned

Sep 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1639892862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 N 1ST ST",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970713210",
            "telephone_number": "503-489-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19300 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627706",
            "telephone_number": "503-692-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "MELISSA",
        "middle_name": "BROOK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "OR",
            "license": "201011830CNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNA2",
            "identifier": "201011830CNA",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Meerdter
• Christina Mehanni, MD
• Melody Jones, Pmhnp, LLC
• Melody Jones, Pmhnp, LLC
• Debra L Mende, R.N.
• Linn Rey Menzie Sr., LCSW
• Meridian Center for Surgical Excellence
• Meridian Family Care, LLC
• Meridian Park Oncology LLC
• Meridian Park Radiation Oncolog Center, Inc

• Forensic Psychiatry Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Forensic Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.