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Contact Information

MELISSA PENDERGRASS, MD
19875 SW 65TH AVE STE 250
TUALATIN, OR97062-8353
 Phone: 503-612-5260
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Women

282NW0100X
Indicates primary specialty

NPI Profile & details for MELISSA PENDERGRASS · (Female)

NPI # 1649463118
Status Active
Credentials MD
Entity Individual
Enumeration date 08/19/2007
Last updated 09/06/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 125-053708
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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