Individual
MS. MARY BETH BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4015 MERCANTILE DR, STE 200, LAKE OSWEGO, OR 97035-2552
(503) 216-1500
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
089006127N1
OR
363LF0000X
Family Nurse Practitioner
3007648
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274252
—
OR
Enumeration date
07/10/2007
Last updated
10/19/2020
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