Individual
MARY C MAMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1255 SW CHAD DRIVE, # 2066, WALDPORT, OR 97394-2066
(541) 961-8805
(541) 563-6974
Mailing address
1255 SW CHAD DRIVE, PO BOX 2066, WALDPORT, OR 97394
(541) 961-8805
(541) 563-6974
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098279
—
OR
Enumeration date
09/28/2006
Last updated
07/09/2007
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