Individual provider · Type 1 NPI

Marivic Rustia

Acute Care Nurse Practitioner · Portland, OR

NPI number 1376012104 Active

Practice location

2222 NW Lovejoy St Ste 411
Portland, OR 97210-5102

Mailing address

255 SW Harrison St Apt 11D
Portland, OR 97201-5387

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100XAP139794 (TX)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1376012104

Marivic Rustia's National Provider Identifier is 1376012104, issued on Nov 21, 2018. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Portland, OR. The record was last updated on Oct 12, 2021.