MEDICARE: MARGARET MARY MCSORLEY CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN00085262	WA
2	367500000X	Certified Registered Nurse Anesthetist	AP30004482	WA
3	163W00000X	Registered Nurse		OR
4	367500000X	Certified Registered Nurse Anesthetist		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215964622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET MARY MCSORLEY CRNA

Provider Business Mailing Address
First Line	:	PO BOX 4008
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-4008
Country	:	US
Telephone Number	:	503-372-2740
Fax Number	:	503-372-2754

Provider Business Practice Location Address
First Line	:	6446 SW BORLAND RD
Second Line	:	SUITE A3
City	:	TUALATIN
State	:	OR
Zip	:	97062-9798
Country	:	US
Telephone Number	:	971-404-3366
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	09/11/2025

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