Mary C Carlyle, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1168 Issued in OR

Practice address

4855 SW Western Ave
Beaverton, OR 97005-3460

Phone

(503) 277-1344

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chris Carlyle Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1801809355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 SW WESTERN AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053460",
            "telephone_number": "503-277-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 SW WESTERN AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053460",
            "telephone_number": "503-277-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4855 SW Western Ave",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970053460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "CARLYLE",
            "credential": "MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Marie Carle
• Michael Carlip, BCBA
• Julie Carlson
• Traci Carlson, O.T.R.
• Stephanie Nicole Carlston
• Theresa Carmody, LMFT
• Montserrat Caro
• Carol Butler-Paisley, FNP, Pmhnp, LLC
• Noah Carolan, M.ED
• Angela Carpenter, BS, RDH, EPP

• Professional Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.