Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Marisa Protasel Johnson, PMHNP-BC

Individual provider Registered Nurse · NPI 1699011767

Mrs. Marisa Protasel Johnson, PMHNP-BC is a Nurse Practitioner in Portland, Oregon. Qualified in 2019, 7 years ago. Practices with Native American Rehabilitation Assoc Inc, an 18-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois, Oregon and Washington.

Years since qualifying
7
Licensed in
IL, OR, WA
In the registry since
2012
Specialties on file
6
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

12360 E Burnside St
Portland, OR 97233-1042
Phone: (971) 279-4800
Fax: (971) 279-2051
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 703 Ne Hancock St, Portland, OR 97212-3955 — (503) 230-9875

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 202208550NP-PP (OR)
Registered Nurse Taxonomy 163W00000X · Licence RN60200108 (WA)
Nurse Practitioner Taxonomy 363L00000X · Licence AP61312604 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 209.021409 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 202208453RN (OR)
Registered Nurse Taxonomy 163W00000X · Licence 041495198 (IL)

Record details

NPI number1699011767
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedDecember 18, 2012
Last updated in NPPESMarch 21, 2024
Certification dateMarch 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Native American Rehabilitation Assoc Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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