Individual
MARY K BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2415 SE 43RD AVE, SUITE 100, PORTLAND, OR 97206-1600
(503) 963-2575
(503) 872-0116
Mailing address
2415 SE 43RD AVE, SUITE 100, PORTLAND, OR 97206-1600
(503) 963-2575
(503) 872-0116
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
OR
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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