Provider Demographics
NPI:1982447942
Name:MCGRATH, MARIE HELENA
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:HELENA
Last Name:MCGRATH
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:THEO
Other - Middle Name:
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5415 SW WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2409
Mailing Address - Country:US
Mailing Address - Phone:036-453-5815
Mailing Address - Fax:
Practice Address - Street 1:8770 SW SCOFFINS ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6226
Practice Address - Country:US
Practice Address - Phone:503-684-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator