Individual
MAGEN ELISE MERTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
(503) 963-7124
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201501603RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10014463
OR
Other
Enumeration date
04/03/2023
Last updated
08/23/2023
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