Individual
MS. MARSHA MARRE STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1303
(503) 494-6868
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1303
(503) 494-6868
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
000036205N2
OR
363LP0200X
Pediatric Nurse Practitioner
AP30002170
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9604851
—
WA
Enumeration date
07/08/2006
Last updated
05/19/2014
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