Provider Demographics
NPI:1801990031
Name:DURAN, MARY BEL (RN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BEL
Last Name:DURAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 N SPRINGBROOK RD # 119
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2007
Mailing Address - Country:US
Mailing Address - Phone:503-538-3195
Mailing Address - Fax:
Practice Address - Street 1:1102 N SPRINGBROOK RD # 119
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2007
Practice Address - Country:US
Practice Address - Phone:503-538-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR098084Medicaid