Individual provider Active NPI

Mary Maher Olson, DO

  • Pediatrics Physician
  • Tigard, OR
National Provider Identifier
1891024907
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO150422 Issued in OR
Practice address
12442 SW Scholls Ferry Rd
Suite 205
Tigard, OR 97223-3396
Phone
(503) 579-3214
Fax
(503) 579-2027
NPI assigned
Dec 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO150422 OR Primary

Addresses

Primary practice location

12442 SW Scholls Ferry Rd
Suite 205
Tigard, OR 97223-3396

Mailing address

11790 SW Barnes Rd., BLDG. a., Ste. 140
Portland, OR 97225
Phone (503) 579-3214

Other names 1

  • Mary Maher Nawar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO150422ORMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1891024907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11790 SW BARNES RD., BLDG. A., STE. 140",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-579-3214",
            "fax_number": "503-579-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12442 SW SCHOLLS FERRY RD",
            "address_2": "SUITE 205",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233396",
            "telephone_number": "503-579-3214",
            "fax_number": "503-579-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MARY",
        "middle_name": "MAHER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-18",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO150422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "NAWAR",
            "middle_name": "MAHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.