| Doctor Name: | MARY C MAMER |
| NPI Number: | 1568554525 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | |
| Business Practice Address: | 1255 Sw Chad Drive # 2066 Waldport, OR - 973942066 |
| Business Phone Number: | 5419618805 |
| Business Fax Number: | 5415636974 |
| Mailing Address: | 1255 Sw Chad Drive, Po Box 2066 WALDPORT |
| State: | OR |
| Postal Code: | 97394 |
| Phone Number: | 5419618805 |
| Fax Number: | 5415636974 |
| NPI Enumeration Date: | 09/28/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |