Marissa Colberg
Individual provider Active NPI Doula · Stayton, OR
NPI 1548043078 · NPPES record last updated Aug 17, 2023
Key facts
- NPI
- 1548043078
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Doula 374J00000X
- License
- 109526 (OR)
- Practice address
- 39939 Mertz Dr SE
Stayton, OR 97383-9404 - Phone
- (503) 890-7865
- NPI assigned
- Aug 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109526 | OR | MD | Doula |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | 109526 | OR | Yes |
Addresses
Primary practice location
39939 Mertz Dr SE
Stayton, OR 97383-9404
Mailing address
39939 Mertz Dr SE
Stayton, OR 97383-9404
Phone (503) 890-7865
Other names
- Marissa Palin
Other providers in Stayton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.