Active NPI
Mark M Marshall, FNP-C
- Family Nurse Practitioner
- Battle Ground, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP61027928
- Practice address
- 2005 W Main St
Battle Ground, WA 98604-4311 - Phone
- (360) 882-2778
- NPI assigned
- Aug 30, 2018
- Last updated
- Sep 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 202001365NP-PP | OR | |
| Family Nurse Practitioner | 363LF0000X | 21984 | SC | |
| Family Nurse Practitioner | 363LF0000X | AP61027928 | WA | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | AP61027928 | WA |
Addresses
Primary practice location
2005 W Main St
Battle Ground, WA 98604-4311
Mailing address
PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21984 | SC | MD | Dermatology Physician |
| AP61027928 | WA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| Sea Mar Community Health Centers | Nurse Practitioner | Current | Accepting new patients |
| Sea Mar Community Health Centers | Nurse Practitioner | Current | Accepting new patients |
| Sea Mar Community Health Centers | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| Booker Family Practice, LLC | Past | Accepting new patients |
Locations
118 S Parkway Ave
Battle Ground, WA 98604
Phone (360) 342-8050
2005 W Main St
Battle Ground, WA 98604
Phone (360) 604-1600
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
7410 Delaware Ln
Vancouver, WA 98664
Phone (360) 566-4402
Interoperability endpoints
- mmarshal@yourcarecommunity.org
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.
-
dba Sea Mar Community Health Center
- Federally Qualified Health Center (FQHC)
- Aberdeen, WA
- NPI 1811051170
Nurse Practitioner
-
dba The Vancouver Clinic
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
-
- Federally Qualified Health Center (FQHC)
- Vancouver, WA
- NPI 1871961680
Nurse Practitioner
-
- Federally Qualified Health Center (FQHC)
- Spanaway, WA
- NPI 1922624642
-
dba Salmon Creek 2 Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
-
- Family Medicine Physician
- West Union, SC
- NPI 1871413468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1548742190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4825",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084825",
"telephone_number": "360-882-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 W MAIN ST",
"city": "BATTLE GROUND",
"state": "WA",
"postal_code": "986044311",
"telephone_number": "360-882-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "MARK",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-30",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "202001365NP-PP",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "21984",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP61027928",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "WA",
"license": "AP61027928",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Battle Ground, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.