Melissa Anne Phelan, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61585607 Issued in WA

Practice address

10000 NE 7TH Ave Ste 410
Vancouver, WA 98685-4548

Phone

(360) 836-0313

Fax

(833) 553-2040

NPI assigned

Jan 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 5, 2025 through Feb 5, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1760197990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE STE 410",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854548",
            "telephone_number": "360-836-4455",
            "fax_number": "833-553-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE STE 410",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854548",
            "telephone_number": "360-836-0313",
            "fax_number": "833-553-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10030523",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61585607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long G Phan, PHARMACIST
• Khaled Rashad Pharaon, MD
• Pharmacy Corporation of America
• Pharmacy Corporation of America
• Mary Catherine Phelan, LMP
• Alayson Lynette Phelps, D.V.M.
• Lynaire Anne Phelps
• Leslie A Phernetton, PTA
• Nyakusaga Philip, AAC
• Cara M Phillipo, N.D. L.AC

• Psychiatric/Mental Health Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.