MELINDA LEE HERBAUGH CONRAD MA PCA
NPI 1639684400
Counselor - Mental Health in Portland, OR
Active since December 02, 2017
About Melinda Lee Herbaugh Conrad Ma Pca NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MELINDA LEE HERBAUGH CONRAD MA PCA (NPI 1639684400) is an individual mental health provider in Portland, Oregon, licensed in Oregon (R12092) and active in the NPI registry since December 2017.
NPPES Registry Identity
NPI1639684400
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMELINDA LEE HERBAUGH CONRADCredential: MA PCA
Location Address1706 NE 53RD AVEPortland, OR 97213-2740
Mailing Address1706 Ne 53rd AvePortland, OR 97213-2740 · (503) 662-9212 · Fax (503) 882-4564
Phone(503) 662-9212
Fax(503) 882-4564
Sole ProprietorYes
Enumeration DateDecember 2, 2017
Last NPPES UpdateJanuary 7, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2026
✔ NPI 1639684400 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · R12092
1706 NE 53RD AVE, Portland, OR 97213
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639684400, enumerated as an "individual" on December 02, 2017.
The provider is located at 1706 NE 53RD AVE PORTLAND, OR 97213 and the phone number is (503) 662-9212.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
