Active NPI
Mara Otterstad, MHP
- Counselor
- Vancouver, WA
National Provider Identifier
1447550306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60166030
- Practice address
- 6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7369 - Phone
- (360) 993-3000
- Fax
- (360) 993-3047
- NPI assigned
- Oct 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60166030 | WA | Primary |
Addresses
Primary practice location
6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7369
Mailing address
PO Box 1337
Vancouver, WA 98666-1337
Phone (360) 993-3000
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
| License | State | Type | Specialty |
|---|---|---|---|
| CG60166030 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1447550306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1337",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986661337",
"telephone_number": "360-993-3000",
"fax_number": "360-993-3047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6926 NE FOURTH PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986617369",
"telephone_number": "360-993-3000",
"fax_number": "360-993-3047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTERSTAD",
"first_name": "MARA",
"credential": "MHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-26",
"last_updated": "2010-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60166030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.