Individual provider Active NPI

Elizabeth Marie Marik, FNP-C

  • Family Nurse Practitioner
  • Woodburn, OR
National Provider Identifier
1750351185
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
091006812N1 FNP-PP Issued in OR
Practice address
1475 Mount Hood Ave
Woodburn, OR 97071-9066
Phone
(971) 983-5341
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 091006812N1 FNP-PP OR Primary

Addresses

Primary practice location

1475 Mount Hood Ave
Woodburn, OR 97071-9066

Mailing address

1475 Mount Hood Ave
Woodburn, OR 97071-9066
Phone (971) 983-5341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060227000696 OR Practitioner - Nurse Practitioner 1456367655 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
091006812N1 FNP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health CurrentSince Aug 16, 2009 Accepting new patients
Silverton Health Current Accepting new patients
Silverton Health CurrentSince Aug 16, 2009 Accepting new patients
Silverton Health Past Accepting new patients
Providence Medical Group, PC Past Accepting new patients

Locations

5685 Inland Shores Way N
Keizer, OR 97303
Phone (503) 779-2271

861 W Main St
Molalla, OR 97038
Phone (503) 829-7344

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

335 Fairview St
Silverton, OR 97381
Phone (503) 873-4115

1475 Mount Hood Ave
Woodburn, OR 97071
Phone (503) 982-2174

1475 Mount Hood Ave
Ste 130
Woodburn, OR 97071

1475 Mount Hood Ave
Ste 110
Woodburn, OR 97071
Phone (971) 983-5360

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750351185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 MOUNT HOOD AVE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719066",
            "telephone_number": "971-983-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MOUNT HOOD AVE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719066",
            "telephone_number": "971-983-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIK",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "091006812N1 FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.