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Marisa Wickerath, MD
NPI 1962088641 · on the registry since 2021
Practice
- Address
- 1825 Maple St
Forest Grove, OR 97116 - Phone
- (503) 357-2136
- Organisation at this address
- Maple Street Clinic, Pc
Maple Street Clinic Pharmacy Llc
Managed Health Care Of Oregon I LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 10
Additional practice sites
- 310 S Roosevelt St, Goldendale, WA
Registry record
- Primary taxonomy
- Family Medicine Physician
207Q00000X
- Also registered as
- Emergency Medicine Physician
- Licence states on file
- OR, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-10-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon