Provider Demographics
NPI:1811176605
Name:SOLLER, MARIE VALENTINE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:VALENTINE
Last Name:SOLLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:16110 SW REGATTA LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8942
Mailing Address - Country:US
Mailing Address - Phone:503-690-3527
Mailing Address - Fax:503-536-6660
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD # UHN80
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-9671
Practice Address - Fax:503-346-8219
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1017352084P0800X
ORMD1525932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty