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General NPI Number Information
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NPI Number | 1316914203
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Entity Type | Individual
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Provider Name | MARY E BARTLETT APRN
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 51377 SW OLD PORTLAND RD STE C
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City | SCAPPOOSE
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State | OR
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Zip | 97056-4023
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Country | US
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Telephone | 503-418-4222
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Fax | 503-418-4223
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Provider Business Mailing Address
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Address Line | 51377 SW OLD PORTLAND RD STE C
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City | SCAPPOOSE
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State | OR
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Zip | 97056-4023
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Country | US
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Telephone | 503-418-4222
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Fax | 503-418-4223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201507623NP-PP
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License Number State | OR
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