Individual
MARY REGIS MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, FNP, CNM
Contact information
Practice address
9701 SW BARNES RD STE 200, PORTLAND, OR 97225-6689
(503) 734-3700
(503) 473-8462
Mailing address
7650 SW BEVELAND RD, SUITE 200, PORTLAND, OR 97223-8692
(503) 657-1071
(503) 657-3321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
200250134NP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200250134NP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202011103NP-PP
OR
367A00000X
Advanced Practice Midwife
200550173NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232035
—
OR
Enumeration date
08/04/2006
Last updated
11/08/2022
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