Individual
LAUREN MARA LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, AGNP-C
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
Mailing address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200740341RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201391237NP-PP
OR
363LF0000X
Family Nurse Practitioner
60401667
WA
Other
Enumeration date
05/07/2013
Last updated
08/06/2013
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