Mary Wells (NPI# 1922485135, PAC ID# 9234443227) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1922485135 |
| PAC ID by PECOS | 9234443227 |
| Professional Enrollment ID | I20150804006136 |
| Full Name | Mary Wells |
| Organization Legal Name | THE WALLACE MEDICAL CONCERN |
| Address |
124 Ne 181st Ave Suite 103 Portland OR 97230-6565 |
| Phone Number | 5034891760 |
| Gender | F |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2365680865 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380061 | PROVIDENCE PORTLAND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 | 5034891760 | THE WALLACE MEDICAL CONCERN |
| Organization Legal Name | THE WALLACE MEDICAL CONCERN |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori-ann Lima | Nurse Practitioner | The Wallace Medical Concern | 254 Nw Burnside Rd, Gresham, OR 97030-3836 |
| Julia A Frey | Physician Assistant | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| April D Urquidez | Nurse Practitioner | The Wallace Medical Concern | 254 Nw Burnside Rd, Gresham, OR 97030-3836 |
| Annie H Chisholm | Nurse Practitioner | The Wallace Medical Concern | 254 Nw Burnside Rd, Gresham, OR 97030-3836 |
| Bethany Stairs I | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Angela Kern | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Katherine T Bucciantini | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Briana J Mejia | Family Practice | The Wallace Medical Concern | 254 Nw Burnside Rd, Gresham, OR 97030-3836 |
| Thomas S Stewart | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Street Address |
124 NE 181ST AVE SUITE 103 |
| City | PORTLAND |
| State | OR |
| Zip | 97230-6565 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julia A Frey | Physician Assistant | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Bethany Stairs I | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Angela Kern | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Katherine T Bucciantini | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Thomas S Stewart | Nurse Practitioner | The Wallace Medical Concern | 124 Ne 181st Ave, Suite 103, Portland, OR 97230-6565 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stefani K Cozine | Audiologist | Kaiser Foundation Health Plan of The Northwest | 13705 Ne Airport Way C, Portland, OR 97230-1048 |
| Edward R Mann | Nurse Practitioner | Kaiser Foundation Health Plan of The Northwest | 13705 Ne Airport Way C, Portland, OR 97230-1048 |
| Gordon M Arnott | Family Medicine | American Current Care Pa | 12518 Ne Airport Way, 110 Concentra Urgent Care, Portland, OR 97230-1090 |
| Larry Drumm | Osteopathic Manipulative Medicine | American Current Care Pa | 12518 Ne Airport Way, 110 Concentra Urgent Care, Portland, OR 97230-1090 |
| James Barger | Nurse Practitioner | American Current Care Pa | 12518 Ne Airport Way, 110 Concentra Urgent Care, Portland, OR 97230-1090 |
| Andrew R Harbison | Internal Medicine | American Current Care Pa | 12518 Ne Airport Way, 110 Concentra Urgent Care, Portland, OR 97230-1090 |
| Ryan Stallings | Family Practice | American Current Care Pa | 12518 Ne Airport Way, Portland, OR 97230-1090 |
| Leonardo T Porreco | Physical Therapy | Oregon Physical Therapy and Sports | 3620 Ne 122nd Ave C, Portland, OR 97230-1365 |
| Marc M Morishige | Physical Therapy | Oregon Physical Therapy and Sports | 3620 Ne 122nd Ave C, Portland, OR 97230-1365 |
| Leslie Franson | Podiatry | 1701 Ne 122nd Ave, Portland, OR 97230-1914 | |
| Find all physicians in zip 97230 | |||
| City | PORTLAND |
| Zip Code | 97230 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | PORTLAND + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Mary Wells.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.