NPI 1164791992

Mary Jane Haake, CPCP

Practitioner Medical Art Specialist/Technologist Portland, OR

Practice location

Address: 1017 SW Morrison St 205, Portland, OR 97205-2635
Phone: (503) 224-8416
Fax: (503) 973-5433

Registered specialties

Medical Art Specialist/Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZA2600X Licence EPT-T-652245 (OR)

Other Specialist/Technologist, Other providers in Oregon →

Registry record

NPI: 1164791992
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Dec 2011
Record last updated: 22 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.