Individual
MS. MARY THERESE MARCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
7122 SE SHORT RD, GRESHAM, OR 97080-9094
(503) 663-7172
Mailing address
7122 SE SHORT RD, GRESHAM, OR 97080-9094
(503) 663-7172
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
078040195ANPPP
OR
363LA2200X
Adult Health Nurse Practitioner
AP30007622
WA
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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