Mair Marsiglio Jetmalani, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2534 Issued in OR

Practice address

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Phone

(503) 220-8262

NPI assigned

Aug 3, 2015

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

Other identifiers 1

Other names 1

• Mary Marsiglio Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Oregon Health & Science University

  • Rural Health Clinic/Center
  • Scappoose, OR
  • NPI 1417969304
  Medicare reassignment NPD
• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment NPD
• Oregon Health & Science University

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1457129678
  NPD
• Oregon Health & Science University

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1477675148
  NPD
• University Professional Services

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1750753687
  NPD

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1336525252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 NE HANCOCK ST",
            "address_2": "APT 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972124474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 S Bond Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972394501",
            "country_code": "US",
            "telephone_number": "503-494-3457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSIGLIO JETMALANI",
        "first_name": "MAIR",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500765636",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MARSIGLIO",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Marshall, GCFP
• Terry Marshall, LMFT
• William Francis Marshall Jr., MD
• Kyra Marsico
• Amanda Christine Marsiglia, PA-C
• Linda Marsteller
• Brooke Marston
• Carissa Angela Marston
• Julie Ann Martchenke, PNP
• Christopher Martel, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.