Provider Demographics
NPI:1205727856
Name:ZELLINGER, MARA (BSN, RN, CDCES)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:ZELLINGER
Suffix:
Gender:F
Credentials:BSN, RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 GREENRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1476
Mailing Address - Country:US
Mailing Address - Phone:813-391-7183
Mailing Address - Fax:
Practice Address - Street 1:6475 SW BORLAND RD STE L
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9708
Practice Address - Country:US
Practice Address - Phone:503-692-2300
Practice Address - Fax:503-692-2547
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202100248RN163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator