Melinda Pilar Anello

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Portland, OR

NPI 1912675729 · NPPES record last updated Oct 10, 2023

Key facts

NPI
1912675729
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
10008344 (OR)
Practice address
6400 SE Lake Rd
Portland, OR 97222-2129
Phone
(503) 447-3285
NPI assigned
Sep 6, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OR, WA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230821002227 OR Practitioner - Nurse Practitioner 9830551035
I20240402004142 WA Practitioner - Nurse Practitioner 9830551035

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10008344ORMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10008344 OR Yes

Addresses

Primary practice location

6400 SE Lake Rd
Portland, OR 97222-2129

Mailing address

14212 SE Rupert Dr
Milwaukie, OR 97267-1204
Phone (503) 206-2435

Other providers in Portland, OR

All providers in Portland, OR · Psychiatric/Mental Health Nurse Practitioner in Oregon

Sources for this page

Verify at the official NPI Registry.