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Provider Information for 1932630225

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MELISSA ALEXANDRA LEWIS

Gender: FEMALE

Individual NPI: 1932630225

Calendar   Last Updated:  2020-01-14
  Certification Date:  2020-01-14

Details

Name Value
NPI 1932630225
Enumeration Date 2017-03-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 8915 SW CENTER ST
TIGARD, OR 97223-6307
United States

Phone: 503-726-3690 | Fax:
View Map External Link
Primary Practice Address 24499 SW GRAHAMS FERRY RD
WILSONVILLE, OR 97070-7523
United States

Phone: 503-238-0769 | Fax:
View Map External Link
Secondary Practice Address 8915 SW CENTER ST
TIGARD, OR 97223-6307
United States

Phone: 503-726-3690 | Fax:
View Map External Link

2020 SE POWELL BLVD
PORTLAND, OR 97202-2345
United States

Phone: 503-233-6121 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 101YA0400X - Counselor Addiction (Substance Use Disorder)
No 101YM0800X - Counselor Mental Health
No 106S00000X - Behavior Technician