Individual
MEILANI JO PANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(808) 315-5008
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(808) 315-5008
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
Primary
RBT-22-233076
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BACB829258
BACB ID NUMBER
HI
01
—
RBT-22-233076
RBT NUMBER
HI
Enumeration date
09/07/2022
Last updated
08/11/2025
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