MRS. MARY ANN CUSTER FNP NPI 1891972865

NPI Information

  • NPI: 1891972865
  • Provider Name: MRS. MARY ANN CUSTER, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 18040 SW LOWER BOONES FERRY RD
    SUITE 100
    TIGARD, OR
    ZIP 97224
  • Phone: (503) 216-0700

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NPI Details

MRS. Mary Ann Custer, FNP is a family nurse practitioner in Tigard, OR. MRS. Mary Ann Custer, FNP NPI is 1891972865. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR
ZIP 97224-258
Phone: (503) 216-0700

The enumeration date for this NPI number is 1/22/2008 and was last updated on 10/28/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily200850006NPOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1R157298MEDICARE PINOREGON
2218626MEDICAIDOREGON
3R146642MEDICARE PINOREGON
4R143492MEDICARE PINOREGON
5R157299MEDICARE PINOREGON
6P00650720OTHEROREGONRR MEDICARE
7R143601MEDICARE PINOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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