Active NPI
Christopher Marquardt, NCC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1174976393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R3962
- Practice address
- 2304 E Burnside St Ste 3
Portland, OR 97214-1677 - Phone
- (971) 270-0792
- NPI assigned
- Jul 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R3962 | OR | Primary |
Addresses
Primary practice location
2304 E Burnside St Ste 3
Portland, OR 97214-1677
Mailing address
2304 E Burnside St Ste 3
Portland, OR 97214-1677
Phone (971) 270-0792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 26, 2024 through Jun 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3962 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1174976393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2304 E BURNSIDE ST STE 3",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141677",
"telephone_number": "971-270-0792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2304 E BURNSIDE ST STE 3",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141677",
"telephone_number": "971-270-0792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARQUARDT",
"first_name": "CHRISTOPHER",
"credential": "NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R3962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.