Individual
MELISSA BROOK MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19300 SW 65TH AVE, TUALATIN, OR 97062-7706
(503) 692-1212
Mailing address
1128 N 1ST ST, WOODBURN, OR 97071-3210
(503) 489-3504
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
201011830CNA
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201011830CNA
CNA2
OR
Enumeration date
09/22/2022
Last updated
09/22/2022
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