Individual provider Active NPI

Emily Tess Demarco, MD

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1366882177
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD182181 Issued in OR
Practice address
4824 NE 42ND Ave # 177
Portland, OR 97218-1661
Phone
(503) 758-9588
NPI assigned
Jun 26, 2013
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X MD182181 OR Primary

Addresses

Primary practice location

4824 NE 42ND Ave # 177
Portland, OR 97218-1661

Mailing address

3181 SW Sam Jackson Park Rd
Ohsu
Portland, OR 97239-3011
Phone (503) 494-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD182181ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Growth and Wellness LLC CurrentSince Oct 4, 2020 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Sep 14, 2019 Accepting new patients
Lifeworks NW CurrentSince Sep 23, 2020 Accepting new patients
Ubh of Oregon, LLC CurrentSince Aug 9, 2017 Accepting new patients
Legacy Emanuel Hospital & Health Center Psychiatry CurrentSince Sep 14, 2019 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients

Locations

971 SW Walnut St
Hillsboro, OR 97123
Phone (503) 640-5297

10300 SW Eastridge St
Portland, OR 97225
Phone (503) 944-5000

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

4824 NE 42nd Ave
#177
Portland, OR 97218
Phone (503) 758-9588

5415 SW Westgate Dr
Portland, OR 97221
Phone (503) 645-9010

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1366882177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "OHSU",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 NE 42ND AVE # 177",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181661",
            "telephone_number": "503-758-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "EMILY",
        "middle_name": "TESS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD182181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.