Provider Demographics
NPI:1346366523
Name:MESNIER, NATALIE SQUIRES
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:SQUIRES
Last Name:MESNIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 NE HOYT ST STE 626
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2956
Mailing Address - Country:US
Mailing Address - Phone:503-231-1426
Mailing Address - Fax:503-231-0316
Practice Address - Street 1:5050 NE HOYT ST STE 626
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2956
Practice Address - Country:US
Practice Address - Phone:503-231-1426
Practice Address - Fax:503-231-0316
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048044207XX0004X
MDD0064880207XX0004X
ORMD29433207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213816Medicaid
ORR150210Medicare PIN