DR. LAURA MELLICK MD NPI 1851354872

NPI Information

NPI: 1851354872
Provider Name: DR. LAURA MELLICK, MD
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
25 NW 23RD PL
SUITE 11
PORTLAND, OR
ZIP 97210
Phone: (503) 305-6262
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DR. Laura Mellick, MD is a general practice in Portland, OR. DR. Laura Mellick, MD NPI is 1851354872. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

25 NW 23RD PL
SUITE 11
PORTLAND, OR
ZIP 97210-580
Phone: (503) 305-6262
Fax: (503) 305-6078

The enumeration date for this NPI number is 4/10/2006 and was last updated on 9/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		MD17993	OREGON	No
2	208D00000X	General Practice		MD17993	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8182214	MEDICAID	WASHINGTON
2	F09268	MEDICARE UPIN
3	R143152	MEDICARE PIN	OREGON
4	208975	OTHER		WA L & I
5	057252	MEDICAID	OREGON
6	P00232006	MEDICARE PIN	OREGON
7	R132022	MEDICARE PIN
8	858543007	OTHER		REGENCE BC/BS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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