Individual
MARCIA MARIE NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
412 SW 12TH AVE, PORTLAND, OR 97205-2329
(503) 228-7134
Mailing address
10345 NE CLACKAMAS ST APT 16, PORTLAND, OR 97220-3997
(503) 408-7683
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
—
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
000043616N6
OR
Other
Enumeration date
03/10/2008
Last updated
03/13/2008
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