Provider Demographics
NPI:1700536208
Name:ROBINSON, MARY ROSE
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ROSE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1356 SE 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7351
Mailing Address - Country:US
Mailing Address - Phone:541-600-2160
Mailing Address - Fax:
Practice Address - Street 1:1356 SE 28TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-7351
Practice Address - Country:US
Practice Address - Phone:541-600-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula