Provider Demographics
NPI:1790599074
Name:NORBECK, MARY E (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:NORBECK
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 HAWTHORNE AVE NE APT 216
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-6774
Mailing Address - Country:US
Mailing Address - Phone:503-463-6499
Mailing Address - Fax:503-304-2224
Practice Address - Street 1:2110 MISSION ST SE STE 305
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-0038
Practice Address - Country:US
Practice Address - Phone:503-379-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200842532RN163WC1600X, 163WP0808X, 320800000X
OR10044968363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness