KENDALL MELLGREN (NPI# 1144739822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144739822 |
| Entity Type | Individual |
| Full Name | KENDALL MELLGREN |
| Practice Address |
1305 Hill St Se Albany OR 97322-6711 |
| Mailing Address |
Po Box 844 Albany OR 97321-0305 |
| Practice Telephone | 5419676580 |
| Mailing Telephone | 5419676580 |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1305 HILL ST SE |
| City | ALBANY |
| State | OR |
| Zip Code | 97322-6711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225667405 | Nicole Robison | Community Health Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2020-04-08 |
| 1225667413 | Andrew J Sheldon | Peer Specialist | 1305 Hill St Se, Albany, OR 97322-6711 | 2020-04-08 |
| 1275161390 | Jessica Eaker | Community Health Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2020-04-01 |
| 1164061669 | Kim J. King | Community Health Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-12-31 |
| 1932746526 | Bailey D Strayhan | Community Health Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-12-03 |
| 1083258602 | Valeria Jailene Sanchez | Peer Specialist | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-11-06 |
| 1821639394 | Raya Kirtner | Community Health Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-10-04 |
| 1760023899 | Deanna Barclay | Peer Specialist | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-09-30 |
| 1609417732 | Ellie Ritson | Community Health Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-09-30 |
| 1982255543 | Kathryn Rose Hart | Social Worker | 1305 Hill St Se, Albany, OR 97322-6711 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083109748 | Benjamin Voth | Counselor | 1858 Grand Prairie Rd Se, Albany, OR 97322 | 2018-06-26 |
| 1033534748 | Willamette Orthotics & Prosthetics, LLC | Durable Medical Equipment & Medical Supplies | 1630 9th Ave Se, Albany, OR 97322 | 2014-03-04 |
| 1699035998 | Morgan William Brown | Behavioral Analyst | 1885 21 St Ave Se Apt 44, Albany, OR 97322 | 2012-05-21 |
| 1780986059 | Gene Vang | Pharmacist | 1330 Goldfish Farm Rd Se, Albany, OR 97322 | 2010-11-18 |
| 1427362912 | Kate Fredrickson | Speech-Language Pathologist | 5353 Columbus St. Se, Albany, OR 97322 | 2010-07-27 |
| 1689906455 | Sandy Janiszewski | Registered Nurse | 1970 4th Ave. Se, Ste 120, Albany, OR 97322 | 2010-02-04 |
| 1841527066 | Karina Leonore Towers | Speech-Language Pathologist | 5353 Columbus Street Se, Albany, OR 97322 | 2009-11-09 |
| 1548497951 | T.c.s. Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3012 Se Oakwood Avenue, Albany, OR 97322 | 2009-06-12 |
| 1790932952 | Ramel C Romero | Physical Therapist | 5353 Colombus St Se, Albany, OR 97322 | 2008-08-19 |
| 1023275492 | Michael James | Hearing Instrument Specialist | 1610 9th Av. Se, Albany, OR 97322 | 2008-05-21 |
| Find all providers in zip 97322 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| 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. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730711953 | Michael Anthony Duran | Peer Specialist | 1515 Hill St Se, Albany, OR 97322-6715 | 2020-02-05 |
| 1487114674 | Desiree Jeanne Rood | Peer Specialist | 1248 Penn St Sw, Albany, OR 97321-2145 | 2019-03-22 |
| 1912356759 | Veronica Ann Mcclatchey | Peer Specialist | 5050 Columbus St Se Unit 167, Albany, OR 97322-8309 | 2016-06-10 |
| 1225667413 | Andrew J Sheldon | Peer Specialist | 1305 Hill St Se, Albany, OR 97322-6711 | 2020-04-08 |
| 1134768633 | Jon Clifford Phelps | Peer Specialist | 238 3rd Ave Se, Albany, OR 97321-2857 | 2019-12-31 |
| 1215576848 | Sandra Lee Angerbauer | Peer Specialist | 238 3rd Ave Se, Albany, OR 97321-2857 | 2019-12-30 |
| 1114566742 | Matthew Scott Ferguson | Peer Specialist | 238 3rd Ave Se, Albany, OR 97321-2857 | 2019-12-30 |
| 1417592361 | Krista A Drexler | Peer Specialist | 238 3rd Ave Se, Albany, OR 97321-2857 | 2019-11-14 |
| 1063057495 | Andrea Chelsea Dyer | Peer Specialist | 238 3rd Ave Se, Albany, OR 97321-2857 | 2019-11-08 |
| 1477198802 | Lora Jean Sylvester | Peer Specialist | 238 3rd Ave Se, Albany, OR 97321-2857 | 2019-11-08 |
| Find all providers in ALBANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.