Individual
ROBERT ALAN MARICLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-6176
Mailing address
4115 SW NEHALEM CT, PORTLAND, OR 97239-1565
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD10209
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286153
—
OR
Enumeration date
09/20/2006
Last updated
07/08/2007
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