Individual
MOLLY MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3396
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3396
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
20074150RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10042229
OR
Other
Enumeration date
08/19/2024
Last updated
08/04/2025
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