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General NPI Number Information
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NPI Number | 1497511760
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Entity Type | Individual
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Provider Name | MARISA IRENE GILMAN DNP, CNM, ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 1608 SE ANKENY ST
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City | PORTLAND
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State | OR
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Zip | 97214-1448
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Country | US
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Telephone | 503-233-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 11205 SW BOXWOOD CT
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City | TIGARD
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State | OR
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Zip | 97223-4220
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Country | US
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Telephone | 503-382-9108
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Fax |
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 202212292RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 10033269
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License Number State | OR
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