Provider Demographics
NPI:1669653762
Name:MARRAH-PIERSON, ALICIA K (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:K
Last Name:MARRAH-PIERSON
Suffix:
Gender:F
Credentials:CFNP
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Mailing Address - Street 1:2222 NW LOVEJOY ST
Mailing Address - Street 2:STE 505
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-5103
Mailing Address - Country:US
Mailing Address - Phone:503-242-9850
Mailing Address - Fax:503-226-3539
Practice Address - Street 1:20015 SW PACIFIC HWY.
Practice Address - Street 2:STE 221
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140
Practice Address - Country:US
Practice Address - Phone:503-625-2848
Practice Address - Fax:503-625-2899
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2020-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OR200750095NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR142087Medicare UPIN
115292Medicare PIN