KENNETH P MELVIN MD PC NPI 1255501698

NPI Information

NPI: 1255501698
Provider Name: KENNETH P MELVIN, MD, PC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Address: 4035 MERCANTILE DR
SUITE 112
LAKE OSWEGO, OR
ZIP 97035
Phone: (503) 203-1177

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NPI Details

KENNETH P MELVIN, MD, PC is a primary care clinic center in Lake Oswego, OR. KENNETH P MELVIN, MD, PC NPI is 1255501698. The provider is registered as an organization entity type.

The provider's business location address is:

4035 MERCANTILE DR
SUITE 112
LAKE OSWEGO, OR
ZIP 97035-546
Phone: (503) 203-1177
Fax: (503) 203-1178

The provider's authorized official is Kenneth Paul Melvin .
The authorized official title is President and has the following contact phone number (503) 203-1177.

The enumeration date for this NPI number is 2/29/2008 and was last updated on 2/29/2008.

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	261QP2300X	Clinic/Center	Primary Care	MD24232	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	MD24232	OTHER	OREGON	OREGON LICENSE

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: 11/21/2025

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