Individual provider · Type 1 NPI

Marisa Protasel Johnson, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Portland, OR

NPI number 1699011767 Active

Practice location

12360 E Burnside St
Portland, OR 97233-1042

Fax (971) 279-2051

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Other practice locations

  • 703 NE Hancock St, Portland, OR 97212-3955 · (503) 230-9875

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN60200108 (WA)
Nurse Practitioner 363L00000XAP61312604 (WA)
Psychiatric/Mental Health Nurse Practitioner 363LP0808X209.021409 (IL)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X202208550NP-PP (OR)
Registered Nurse 163W00000X202208453RN (OR)
Registered Nurse 163W00000X041495198 (IL)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1699011767

Marisa Protasel Johnson, PMHNP-BC's National Provider Identifier is 1699011767, issued on Dec 18, 2012. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Mar 21, 2024.