Individual
DR. MARY ANN MUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
600 NE 8TH ST, GRESHAM, OR 97030-7317
(503) 988-5155
Mailing address
619 NW 6TH AVE FL 5, PORTLAND, OR 97209-3991
(503) 988-3015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OL60231724
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096511
—
OR
05
—
22959
—
OR
Enumeration date
06/07/2011
Last updated
10/21/2025
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