Provider Demographics
NPI:1164576914
Name:GAREAU, MARGUERITE JEANNE (PMHNP)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:JEANNE
Last Name:GAREAU
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:JEANNE
Other - Last Name:GAREAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP
Mailing Address - Street 1:2929 SW MULTNOMAH BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4025
Mailing Address - Country:US
Mailing Address - Phone:503-998-8346
Mailing Address - Fax:503-972-1373
Practice Address - Street 1:2929 SW MULTNOMAH BLVD
Practice Address - Street 2:STE 208
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4025
Practice Address - Country:US
Practice Address - Phone:503-998-8346
Practice Address - Fax:503-972-1373
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200250045NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR000692Medicaid
OR137567Medicare UPIN