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Mrs. Mary Ann Custer, FNP
Family Nurse Practitioner in Tigard, Oregon
NPI 1891972865

Mary Ann Custer is a Family Nurse Practitioner based in Portland, OR and is specialized in Family. Mary Ann Custer practices in Tigard, OR and has the professional credentials of FNP. The NPI Number for Mary Ann Custer is 1891972865 and holds a License No. 200850006NP (Oregon).

The current practice location address for Mary Ann Custer is 18040 Sw Lower Boones Ferry Rd, Tigard, OR and can be reached out via phone at 503-216-0700.

Location: 18040 Sw Lower Boones Ferry Rd, Tigard, OR, 97208-3158
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891972865
Provider Name
Mary Ann Custer
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
18040 Sw Lower Boones Ferry Rd, Tigard, OR, 97208-3158
Phone Number
503-216-0700
Fax Number
Provider Enumeration Date
01/22/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
218626 05 OR
P00650720 01 OR RR MEDICARE
institution
Provider Business Practice Location Address Details
Address
18040 Sw Lower Boones Ferry Rd
City
Tigard
State
Oregon
Zip
97224-7258
Phone Number
503-216-0700
Fax Number
person
Provider Business Mailing Address Details
Address
18040 Sw Lower Boones Ferry Rd
City
Tigard
State
Oregon
Zip
97224-7258
Phone Number
503-216-0700
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
200850006NP (Oregon)
Definition
Definition to come...
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