Individual provider Active NPI

Marita Tiller, LPC

  • Mental Health Counselor
  • Beaverton, OR
National Provider Identifier
1174846869
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C3380 Issued in OR
Practice address
9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307
Phone
(971) 229-4009
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C3380 OR Primary

Addresses

Primary practice location

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307

Mailing address

PO Box 82819
Portland, OR 97282-0819

Other identifiers 2

IdentifierTypeStateIssuer
0000WDBCHOtherORGROUP MEDICARE
164936MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326003514 OR Practitioner - Mental Health Counselor 8022531474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightspire Health LLC 27 clinicians

Practice addresses (Care Compare)

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307
Phone (971) 229-4009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C3380ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightspire Health, LLC CurrentSince May 1, 2025 Accepting new patients

Locations

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005
Phone (503) 626-9494

825 NE 20th Ave
Ste 120
Portland, OR 97232
Phone (971) 229-4009

10824 SE Oak St
Portland, OR 97222
Phone (717) 516-1080

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.maritatiller@148835.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1174846869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9670 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053307",
            "telephone_number": "971-229-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "MARITA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "0000WDBCH",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.