Individual
MS. BRIDGET JEAN MARICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2850 SE POWELL VALLEY RD, LEGACY GOHEALTH, GRESHAM, OR 97080-1494
(503) 666-5050
(503) 666-1162
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0001462
CO
363A00000X
Physician Assistant
Primary
PA179535
OR
363A00000X
Physician Assistant
PA60599711
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79721206
—
CO
Enumeration date
03/23/2007
Last updated
09/08/2016
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