MARISA LEE DONNELLY
NPI 1295359461
Peer Specialist in Bend, OR

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

Active since June 03, 2020

63311 JAMISON ST, BEND, OR 97703(541) 322-7500(541) 322-7565 Get Directions Write a Review

NPPES record last updated: June 3, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Marisa Lee Donnelly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISA LEE DONNELLY (NPI 1295359461) is an individual peer specialist in Bend, Oregon and active in the NPI registry since June 2020.

NPPES Registry Identity

NPI1295359461

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameMARISA LEE DONNELLY

Location Address63311 JAMISON STBend, OR 97703-8288

Mailing Address2577 Ne Courtney DrBend, OR 97701-7752 · (541) 322-7500 · Fax (541) 322-7565

Phone(541) 322-7500

Fax(541) 322-7565

Sole ProprietorNo

Enumeration DateJune 3, 2020

NPPES CertifiedJune 3, 2020

✔ NPI 1295359461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

63311 JAMISON ST, Bend, OR 97703

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES JOSEPH DEZORT

Peer Specialist