Individual provider Active NPI

Natalie M Martin, QMHP-C

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1295096915
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19-QMHPC-00342 Issued in OR
Practice address
1631 SW Columbia St
Portland, OR 97201-6025
Phone
(971) 261-0544
Fax
(971) 245-3043
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 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 19-QMHPC-00342 OR Primary

Addresses

Primary practice location

1631 SW Columbia St
Portland, OR 97201-6025

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044

Other identifiers 1

IdentifierTypeStateIssuer
500760125MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19-QMHPC-00342ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1295096915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 SW COLUMBIA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972016025",
            "telephone_number": "971-261-0544",
            "fax_number": "971-245-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NATALIE",
        "middle_name": "M",
        "credential": "QMHP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "19-QMHPC-00342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500760125",
            "state": "OR"
        }
    ],
    "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 Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.