Individual
MARISSA CHRISTINE MACEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8122
Mailing address
2241 LLOYD CENTER, PORTLAND, OR 97232
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
201250151NP
OR
Other
Enumeration date
09/20/2012
Last updated
10/29/2013
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