Nurse Practitioner, Pediatrics
MARISA MACKENZIE
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1790505873 · enumerated 2024-10-14 · record updated 2025-03-18. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 3181 SW SAM JACKSON PARK RD, PORTLAND, OR, 97239-3011 (503) 494-5350 Google Maps Apple Maps OpenStreetMap
- Mailing address 3181 SW SAM JACKSON PARK RD, PORTLAND, OR, 97239-3011 (503) 494-5350 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner 363L00000X · License 10032067 OR
- Nurse Practitioner, Pediatrics 363LP0200X · Primary · License 10032067 OR
In this directory
Locations and evidence
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Practice location
PORTLAND, OR, 972393011
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.