Individual
MARY ELIZABETH ROTBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
202 NW 13TH AVE, PORTLAND, OR 97209-2953
(503) 941-3844
(503) 941-3777
Mailing address
19075 NW TANASBOURNE DR STE 200, HILLSBORO, OR 97124-5866
(503) 941-3844
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201606595NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201606595NP-PP
NP LICENSE
OR
Enumeration date
08/23/2016
Last updated
12/30/2021
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