Individual provider Active NPI

Maya Mersal

  • Specialist
  • Vancouver, WA
National Provider Identifier
1669994166
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
316 SE 123Rd Ave Ste A67
Vancouver, WA 98683-4056
Phone
(503) 702-0178
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

316 SE 123Rd Ave Ste A67
Vancouver, WA 98683-4056

Mailing address

3011 SE 142ND PL
Portland, OR 97236-2612
Phone (503) 702-0178

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1669994166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 SE 142ND PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972362612",
            "telephone_number": "503-702-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 SE 123RD AVE STE A67",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834056",
            "telephone_number": "503-702-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERSAL",
        "first_name": "MAYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "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 Nov 19, 2018; 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.