Healthcare Provider Details

I. General information

NPI: 1073482410
Provider Name (Legal Business Name): MARIE MILLAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 SE CIRCUIT DR STE 270
HILLSBORO OR
97123-1966
US

IV. Provider business mailing address

7305 SE CIRCUIT DR STE 270
HILLSBORO OR
97123-1966
US

V. Phone/Fax

Practice location:
  • Phone: 503-207-9463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number201908529RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: