Active NPI
Mariah Mercedes Wyatt
- Counselor
- Vancouver, WA
National Provider Identifier
1568972552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 9300 NE Oak View Dr
Vancouver, WA 98662-6157 - Phone
- (360) 567-2211
- NPI assigned
- Oct 4, 2017
- Last updated
- Sep 8, 2020
- 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 | Primary |
Addresses
Primary practice location
9300 NE Oak View Dr
Vancouver, WA 98662-6157
Mailing address
117 NW Trinity PL Apt 1
Portland, OR 97209-1929
Phone (503) 508-4848
Other practice location 1
1715 SE 32nd Pl
Portland, OR 97214-5016
Phone (503) 508-4848
Other practice location 2
19350 Robin Cir Apt 90
West Linn, OR 97068-2379
Phone (503) 508-4848
Other practice location 3
3415 SE Powell Blvd
Portland, OR 97202-3371
Phone (503) 234-9591
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1568972552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 NW TRINITY PL APT 1",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091929",
"telephone_number": "503-508-4848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 NE OAK VIEW DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986626157",
"telephone_number": "360-567-2211"
}
],
"practiceLocations": [
{
"address_1": "1715 SE 32nd Pl",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972145016",
"country_code": "US",
"telephone_number": "503-508-4848",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "19350 Robin Cir Apt 90",
"address_purpose": "LOCATION",
"city": "West Linn",
"state": "OR",
"postal_code": "970682379",
"country_code": "US",
"telephone_number": "503-508-4848",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3415 SE Powell Blvd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972023371",
"country_code": "US",
"telephone_number": "503-234-9591",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WYATT",
"first_name": "MARIAH",
"middle_name": "MERCEDES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-04",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"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 Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.