Provider Demographics
NPI:1982791745
Name:NEMHAUSER, MARCI J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARCI
Middle Name:J
Last Name:NEMHAUSER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SW MEADOWS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035
Mailing Address - Country:US
Mailing Address - Phone:503-534-3628
Mailing Address - Fax:503-534-3535
Practice Address - Street 1:4800 SW MEADOWS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:503-534-3628
Practice Address - Fax:503-534-3535
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR778103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000TCPBBMedicare ID - Type Unspecified