| Doctor Name: | MARY M TIPPIN |
| NPI Number: | 1316018864 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 094007047 |
| Business Practice Address: | 1475 Mt. Hood Avenue Woodburn, OR - 97071 |
| Business Phone Number: | 9719835252 |
| Business Fax Number: | 9719835253 |
| Mailing Address: | 1475 Mt. Hood Avenue, WOODBURN |
| State: | OR |
| Postal Code: | 97071 |
| Phone Number: | 9719835252 |
| Fax Number: | 9719835253 |
| NPI Enumeration Date: | 11/13/2006 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 094007047 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |