Individual
ELISE J MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP-BC
Contact information
Practice address
1321 NE 99TH AVE, SUITE 100, PORTLAND, OR 97220-9436
(503) 215-4050
Mailing address
1500 NW BETHANY BLVD STE 200, BEAVERTON, OR 97006-5236
(503) 741-2735
(503) 308-7222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201502876NP-PP
OR
363LF0000X
Family Nurse Practitioner
201502876NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201502876NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61239945
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500690415
—
OR
Enumeration date
12/19/2011
Last updated
11/26/2025
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