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General NPI Number Information
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NPI Number | 1942433933
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Entity Type | Individual
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Provider Name | MARY FRANCES CONEDERA PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 21810 WILLAMETTE DR STE 200
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City | WEST LINN
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State | OR
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Zip | 97068-3256
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Country | US
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Telephone | 503-994-4353
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Fax | 833-975-0942
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Provider Business Mailing Address
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Address Line | 21810 WILLAMETTE DR STE 200
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City | WEST LINN
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State | OR
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Zip | 97068-3256
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Country | US
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Telephone | 503-994-4353
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Fax | 833-975-0942
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 200350093NP PMHNP PP
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License Number State | OR
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