Mari Patricia Dominguez, NP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202111998NP-PP Issued in OR

Practice address

2301 Cove Ave
La Grande, OR 97850-3906

Phone

(541) 962-8800

Fax

(541) 963-5272

NPI assigned

Nov 5, 2021

Last updated

Sep 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Human Development IncGroup PAC ID 3678578663, 8 clinicians

New Directions Northwest IncGroup PAC ID 0446572721, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• New Directions Northwest, Inc

  • Community/Behavioral Health Agency
  • Baker City, OR
  • NPI 1235124462
  Medicare reassignment Care Compare group NPD
• Center for Human Development, Inc.

  • Community/Behavioral Health Agency
  • La Grande, OR
  • NPI 1114051315
  Medicare reassignment Care Compare group
• Bridgercare

  • Non-Surgical Family Planning Clinic/Center
  • Bozeman, MT
  • NPI 1700855830
  NPD (past)

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1265197040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503906",
            "telephone_number": "541-962-8800",
            "fax_number": "541-963-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503906",
            "telephone_number": "541-962-8800",
            "fax_number": "541-963-5272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Fir St Ste 327",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978502663",
            "country_code": "US",
            "telephone_number": "541-246-3638",
            "fax_number": "541-234-3777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARI",
        "middle_name": "PATRICIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-05",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202111998NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Dinslage
• Bonnie Marie Dittmann, PA-C
• Trenton Lee Dixon
• Doreen Lynn Dobyns, RN-BC, CDE
• Greg Dombek, DPT
• Alexander Donick, DDS
• Teresa Dowdy
• McKenna Drascic, MSOTR/L
• Korreene Ann Dubray
• Corrine Denise Dutto, M.P.T.

• Psychiatric/Mental Health Nurse Practitioner in La Grande, OR
• Providers in La Grande, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.