Individual
MARY GEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RM
Contact information
Practice address
905 SE 14TH AVE, PORTLAND, OR 97214-2569
(503) 622-8964
Mailing address
905 SE 14TH AVE, PORTLAND, OR 97214-2569
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
201390509RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10028482
OR
Other
Enumeration date
04/03/2024
Last updated
11/19/2024
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