Mark Gavin Dillon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1722 Issued in OR

Practice address

2720 NE 33Rd Ave
Portland, OR 97212-3648

Phone

(503) 281-6162

Fax

(503) 284-1750

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Mark G. Dillon, PH.D.

  • Psychologist
  • Portland, OR
  • NPI 1285914390
  NPD (past) Authorized official

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1295870038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 NE 33RD AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97212",
            "telephone_number": "503-281-6162",
            "fax_number": "503-284-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123648",
            "telephone_number": "503-281-6162",
            "fax_number": "503-284-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "MARK",
        "middle_name": "GAVIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Dilling
• Scott Emerson Dillinger, MSW, LCSW
• Dillon Chiropractic Inc
• Debra Carolyn Dillon, MD
• Laura Winter Dillon, PA
• Sage Dillon, D.C.
• Shaun C Dillon, R.PH.
• Sierra Dillon
• Christopher Cody Dills, DNP
• Peter Thomas Dills

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.