Willow Nicole Naimark, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD150365 Issued in OR

Practice address

2400 SW Vermont St
Portland, OR 97219-1940

Phone

(503) 452-0915

NPI assigned

Jun 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

New York Medical College, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fanno Creek Clinic LLCGroup PAC ID 0042100521, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Fanno Creek Clinic LLC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1609876705
  Medicare reassignment Care Compare group NPD
• Neurothryve

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1851835920
  NPD (past)

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1457556367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191940",
            "telephone_number": "503-452-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191940",
            "telephone_number": "503-452-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIMARK",
        "first_name": "WILLOW",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "OR",
            "license": "MD150365",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD150365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Nahurski
• Yashmira Naidoo, MD
• Padmini Naidu, RPH
• Julie Westlin Naigus, LPC
• Arpana M Naik, MD
• Teresa A Naimo, LPC NCC
• David Naimon, N.D., L.AC.
• Maya Leigh Nair, MD
• Renjith Radhakrishnan Nair, AGACNP
• Jeremy Randolph Naish, CADC-II, QMHA-II

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.