Provider Demographics
NPI:1679724819
Name:WELCH, MARY OSING (RN, PMHNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:OSING
Last Name:WELCH
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 NE SANDY BLVD
Mailing Address - Street 2:# 205 NORTHWEST CATHOLIC COUNSELING CENTER
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4948
Mailing Address - Country:US
Mailing Address - Phone:503-253-0964
Mailing Address - Fax:
Practice Address - Street 1:8383 NE SANDY BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4948
Practice Address - Country:US
Practice Address - Phone:503-253-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200642765RN163W00000X
OR200850133NP PMHNP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse