DR. Marisa Jane Wickerath, MD

NPI #1962088641 in Forest Grove, Oregon

Provider Information

NPI Number: 1962088641
Entity Type: Individual
Name: DR. Marisa Jane Wickerath, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Mar 22, 2021
Last Updated: Oct 23, 2024

Practice Location

Address: 1825 MAPLE ST
City: Forest Grove
State: Oregon
ZIP Code: 97116-1939
Phone: (503) 357-2136

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary
Emergency Medicine	207P00000X

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