Individual
KORIE KATHLYNE MULLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-BC
Contact information
Practice address
13908 SE STARK ST STE A, PORTLAND, OR 97233-2161
(503) 255-2343
Mailing address
13908 SE STARK ST STE A, PORTLAND, OR 97233-2161
(503) 255-2343
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10019170
OR
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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