Mark Gerard Duyck, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8100 Issued in OR

Practice address

17360 Holy Names Dr
Lake Oswego, OR 97034-5133

Phone

(503) 675-2449

NPI assigned

Jul 16, 2015

Last updated

Jul 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Marc Gerard Duyck Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1548644891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 HOLY NAMES DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345133",
            "telephone_number": "503-675-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 HOLY NAMES DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345133",
            "telephone_number": "503-675-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUYCK",
        "first_name": "MARK",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "8100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARC",
            "last_name": "DUYCK",
            "middle_name": "GERARD",
            "prefix": "MR.",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Meredith Joanne Dunn, M.A., L.P.C., LMFT
• Marilyn A Dunning, FNP
• Caitlin D Duran, PT
• Bailey Dutson
• Haley Duvall
• Alyson Anne Dziedzic, MSW
• Darrel Worthley Eacret, PHD
• Jillian Eberhard
• Adrian Bernard Echols, QMHA
• Sara Ann Edmondson, DMD MDS

• Physical Therapy Assistant in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.