Provider Demographics
NPI:1376737445
Name:ROSENSTIEL, MARY ELIZABETH (RN, DNP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:ROSENSTIEL
Suffix:
Gender:F
Credentials:RN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18702 SE RICHEY RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-3323
Mailing Address - Country:US
Mailing Address - Phone:503-492-8137
Mailing Address - Fax:
Practice Address - Street 1:39641 SCENIC ST
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-6405
Practice Address - Country:US
Practice Address - Phone:503-668-5545
Practice Address - Fax:503-668-7951
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR79-032717163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse