Provider Demographics
NPI:1023384922
Name:MULDER-WRIGHT, MELISSA KAY (MSW-LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAY
Last Name:MULDER-WRIGHT
Suffix:
Gender:F
Credentials:MSW-LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:KAY
Other - Last Name:MULDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW-LCSW
Mailing Address - Street 1:PO BOX 3808
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3808
Mailing Address - Country:US
Mailing Address - Phone:503-413-3958
Mailing Address - Fax:503-413-3212
Practice Address - Street 1:2800 N VANCOUVER AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1630
Practice Address - Country:US
Practice Address - Phone:503-413-2901
Practice Address - Fax:503-413-4898
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL47611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical