Kimberly Gamble Marriott, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1189 Issued in OR

Practice address

4036 NE Sandy Blvd
Ste 206
Portland, OR 97212-5335

Phone

(503) 502-2256

Fax

(503) 297-1071

NPI assigned

Nov 9, 2006

Sex

Female

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)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475280000000",
    "number": "1447320833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 NE SANDY BLVD STE 206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125335",
            "telephone_number": "503-297-2287",
            "fax_number": "503-297-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 NE SANDY BLVD",
            "address_2": "STE 206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125335",
            "telephone_number": "503-502-2256",
            "fax_number": "503-297-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRIOTT",
        "first_name": "KIMBERLY",
        "middle_name": "GAMBLE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Marra, DMD
• Cameron Marrelli
• Sarah Marrin, CCC-SLP
• Toni Marrin
• Kathleen Ann Marriott, MS
• Jacqueline Marris
• Fletcher O Marron III, MS
• Anthony David Marrone, D.C.
• Cassandra Marrujo, PHARMD
• Scott William Marsal, MD

• 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 Oct 1, 2016; 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.