Provider Demographics
NPI:1295164044
Name:JONES, MELODY BECKER (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:BECKER
Last Name:JONES
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 CENTERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8203
Mailing Address - Country:US
Mailing Address - Phone:971-356-4110
Mailing Address - Fax:
Practice Address - Street 1:8215 SW TUALATIN SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8620
Practice Address - Country:US
Practice Address - Phone:971-356-4110
Practice Address - Fax:971-223-0946
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201393706NP-PP363LP0808X
WAAP60575174363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health