MELROSE MONA ELLAN MASK PSS
NPI 1871128215
Peer Specialist in Roseburg, OR

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

Active since March 05, 2020

621 W MADRONE ST, ROSEBURG, OR 97470(541) 672-2691 Get Directions Write a Review

NPPES record last updated: May 18, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 18, 2020, Mar 5, 2020 (2 updates tracked since 2020).

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About Melrose Mona Ellan Mask Pss NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELROSE MONA ELLAN MASK PSS (NPI 1871128215) is an individual peer specialist in Roseburg, Oregon, licensed in Oregon (THW000004127) and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1871128215

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameMELROSE MONA ELLAN MASKCredential: PSS

Location Address621 W MADRONE STRoseburg, OR 97470-3090

Mailing AddressPo Box 1121Roseburg, OR 97470-0254

Phone(541) 672-2691

Sole ProprietorNo

Enumeration DateMarch 5, 2020

Last NPPES UpdateMay 18, 20202 updates tracked since enumeration

NPPES CertifiedMay 18, 2020

✔ NPI 1871128215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in OR · THW000004127

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

621 W MADRONE ST, Roseburg, OR 97470

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