Provider Demographics
NPI:1063902047
Name:ISBELL, MARA
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:ISBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 NW BROOKS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2033
Mailing Address - Country:US
Mailing Address - Phone:541-633-4591
Mailing Address - Fax:
Practice Address - Street 1:990 NW BROOKS ST STE 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2033
Practice Address - Country:US
Practice Address - Phone:541-633-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management