Individual
MARY R LIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2800 N VANCOUVER AVE, SUITE 255, PORTLAND, OR 97227-1630
(503) 413-4500
Mailing address
2800 N VANCOUVER AVE, SUITE 255, PORTLAND, OR 97227-1630
(503) 413-4500
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
000034705
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263418
—
OR
Enumeration date
02/27/2006
Last updated
02/23/2011
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