Healthcare Provider Details

I. General information

NPI: 1811131261
Provider Name (Legal Business Name): MARYANN WHIPPLE OGDEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 NE 137TH AVE
VANCOUVER WA
98682
US

IV. Provider business mailing address

8704 N PORTSMOUTH AVE
PORTLAND OR
97203
US

V. Phone/Fax

Practice location:
  • Phone: 360-418-6000
  • Fax:
Mailing address:
  • Phone: 312-533-8992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 60292820
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD157843
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD157843
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: