Individual provider Active NPI

Meron Teshome Mengesha

  • Mental Illness Community Based Residential Treatment Facility
  • Gladstone, OR
National Provider Identifier
1730039082
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Practice address
17305 Craig CT
Gladstone, OR 97027-1268
Phone
(971) 430-5508
NPI assigned
Jan 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X OR Primary

Addresses

Primary practice location

17305 Craig CT
Gladstone, OR 97027-1268

Mailing address

17305 Craig CT
Gladstone, OR 97027-1268
Phone (971) 430-5508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1730039082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17305 CRAIG CT",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271268",
            "telephone_number": "971-430-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17305 CRAIG CT",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271268",
            "telephone_number": "971-430-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGESHA",
        "first_name": "MERON",
        "middle_name": "TESHOME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.

Verify at the official NPI Registry.