| Doctor Name: | MARIJO CLEMENS MEDCRAFT |
| NPI Number: | 1558617365 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN CNS |
| License Number: | 201170001CNS |
| Business Practice Address: | 8495 Crater Lake Hwy Mail Code 10 White City, OR - 975033011 |
| Business Phone Number: | 5418262111 |
| Business Fax Number: | |
| Mailing Address: | 8495 Crater Lake Hwy, Mail Code 10 WHITE CITY |
| State: | OR |
| Postal Code: | 975033011 |
| Phone Number: | 5418262111 |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2012 |
| NPI Last Update Date: | 07/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0600X |
| License Number: | 201170001CNS |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |