Mary W. Lu, MD, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MARY W. LU, MD, LLC

Practice address

1942 NW Kearney St Ste 24
Portland, OR 97209-1465

Phone

(971) 350-8968

NPI assigned

Nov 19, 2019

Organization subpart

No

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

Authorized official

Name

Mary Lu, MDNPI 1336228386

Title

Member

Phone

(971) 350-8968

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Lu, M.D.

  • Psychiatry Physician
  • Portland, OR
  • NPI 1336228386
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1609412204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 NW THURMAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972101941",
            "telephone_number": "350-971-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 NW KEARNEY ST STE 24",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091465",
            "telephone_number": "971-350-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY W. LU, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "971-350-8968",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1336228386",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Anne Stowell LCSW, PC
• Mary Frazel ND
• Mary K. Williams
• Mary Lee Nichols PHD LLC
• Mary Smith Counseling Services
• Marya Deda Inc
• Maryam M. Motlagh DMD PC
• Emil Tristan Marz
• Russell Bennett Marz, ND, LAC
• Sarah J Marzolf, FNP

• 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 Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.