Liedel, Mary R

Liedel, Mary R is an individual health care provider with primary practice located at 2800 N Vancouver Ave Suite 255, Portland OR 97227-1630. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Liedel, Mary R can be contacted via phone (503) 413-4500.

Contact Information

Primary practice address
2800 N Vancouver Ave Suite 255 Portland OR 97227-1630
Phone: (503) 413-4500
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 000034705 Oregon

Profile Details

NPI number 1871569962
LBN Legal business name Liedel, Mary R
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Feb 23rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871569962 NPPES
Oregon MEDICAID 263418

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