Provider Demographics
NPI:1023569381
Name:BELL, MARISA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PMHNP-BC
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Mailing Address - Street 1:1110 SE ALDER ST STE 301
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2400
Mailing Address - Country:US
Mailing Address - Phone:971-328-1565
Mailing Address - Fax:206-385-7376
Practice Address - Street 1:1110 SE ALDER ST STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2400
Practice Address - Country:US
Practice Address - Phone:971-328-1565
Practice Address - Fax:206-385-7376
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60975936363LP0808X
OR202002490NP-PP363LP0808X
MI4704340898363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health