Active NPI
Mary K Marshall, ANP
- Adult Health Nurse Practitioner
- Beaverton, OR
National Provider Identifier
1912914367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- Practice address
- 17225 NW Tucson St
Beaverton, OR 97006-7431 - Phone
- (503) 690-2108
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | OR | Primary |
Addresses
Primary practice location
17225 NW Tucson St
Beaverton, OR 97006-7431
Mailing address
17225 NW Tucson St
Beaverton, OR 97006-7431
Phone (503) 690-2108
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200250139NP ANP-PP | OR | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912914367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17225 NW TUCSON ST",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970067431",
"telephone_number": "503-690-2108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17225 NW TUCSON ST",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970067431",
"telephone_number": "503-690-2108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "MARY",
"middle_name": "K",
"credential": "ANP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.