Individual provider Active NPI

Maria Lynn Williquette, MA

  • Marriage & Family Therapist
  • Portland, OR
National Provider Identifier
1790095883
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1368 Issued in OR
Practice address
1235 SE Division St Ste 104
Portland, OR 97202-1055
Phone
(206) 327-8592
NPI assigned
Oct 7, 2010
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X T1368 OR Primary

Addresses

Primary practice location

1235 SE Division St Ste 104
Portland, OR 97202-1055

Mailing address

7821 SE 29TH Ave
Portland, OR 97202-8832
Phone (425) 349-8300

Other practice location 1

4526 Federal Ave Bldg 1
Compass Health
Everett, WA 98203-2132
Phone (425) 349-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 3, 2025 through Sep 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
T1368ORMDMarriage & Family Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790095883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7821 SE 29TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972028832",
            "telephone_number": "425-349-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION ST STE 104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021055",
            "telephone_number": "206-327-8592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4526 Federal Ave Bldg 1",
            "address_2": "Compass Health",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982032132",
            "country_code": "US",
            "telephone_number": "425-349-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIQUETTE",
        "first_name": "MARIA",
        "middle_name": "LYNN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.