Individual provider Active NPI

Melinda Dawn Roberts Nichols

  • Registered Nurse
  • Wilsonville, OR
National Provider Identifier
1790646412
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
10029649 Issued in OR
Practice address
29345 SW Town Center Loop E Ste 110
Wilsonville, OR 97070-8486
Phone
(503) 582-2100
NPI assigned
Nov 21, 2025
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 10029649 OR Primary

Addresses

Primary practice location

29345 SW Town Center Loop E Ste 110
Wilsonville, OR 97070-8486

Mailing address

25748 SW Canyon Creek Rd Apt A201
Wilsonville, OR 97070-5619
Phone (503) 582-2100

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

State licenses

LicenseStateTypeSpecialty
10029649ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1763683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1790646412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25748 SW CANYON CREEK RD APT A201",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705619",
            "telephone_number": "503-582-2100",
            "fax_number": "503-582-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29345 SW TOWN CENTER LOOP E STE 110",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708486",
            "telephone_number": "503-582-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS NICHOLS",
        "first_name": "MELINDA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-21",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "10029649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.