Healthcare Provider Details

I. General information

NPI: 1295654218
Provider Name (Legal Business Name): MARCY MARILYN MCDOUGALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 6TH ST
OREGON CITY OR
97045-1801
US

IV. Provider business mailing address

2338 17TH AVE
FOREST GROVE OR
97116-2406
US

V. Phone/Fax

Practice location:
  • Phone: 503-319-0885
  • Fax:
Mailing address:
  • Phone: 503-867-2460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number200841226RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: