Basic Information
Provider Information | |||||||||
NPI: | 1801117635 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STRNAD | ||||||||
FirstName: | MELINDA | ||||||||
MiddleName: | J | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | RANKIN | ||||||||
OtherFirstName: | MELINDA | ||||||||
OtherMiddleName: | J | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 568 | ||||||||
Address2: |   | ||||||||
City: | CORNELIUS | ||||||||
State: | OR | ||||||||
PostalCode: | 971130568 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5033528657 | ||||||||
FaxNumber: | 5033528658 | ||||||||
Practice Location | |||||||||
Address1: | 2935 SW CEDAR HILLS BLVD | ||||||||
Address2: |   | ||||||||
City: | BEAVERTON | ||||||||
State: | OR | ||||||||
PostalCode: | 970051342 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5033526000 | ||||||||
FaxNumber: | 5033526080 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/16/2010 | ||||||||
LastUpdateDate: | 11/02/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD178903 | OR | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
No ID Information.