Ashley Marie Wyatt

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3615 NE Grand Ave
Portland, OR 97212-2104

Phone

(503) 281-1166

NPI assigned

Jul 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ash Marie Wyatt Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Owls Nest North Therapy Joint

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1376948232

  Mental Health

  NPD

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1891532495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 SE BELMONT ST APT 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144070",
            "telephone_number": "503-367-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122104",
            "telephone_number": "503-281-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASH",
            "last_name": "WYATT",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer L Wyant, LMT, CMMP
• Lindsay Evelyn Wyant, PAC
• Nedd L Wyant, RN
• Brittany A Wyas
• Ardyn R Wyatt, LCSW
• Ben Wyatt
• Madison Taylor Wyatt
• Solange Marie Wyatt, MD
• Justin Wycoff, LMT
• Olivia Wycoff

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.