Active NPI
Emiko Mar, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1942984380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 64940
- Practice address
- 1515 NW 18TH Ave Ste 400
Portland, OR 97209-2516 - Phone
- (503) 228-1306
- Fax
- (503) 228-1307
- NPI assigned
- Jun 14, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 64940 | OR | Primary |
Addresses
Primary practice location
1515 NW 18TH Ave Ste 400
Portland, OR 97209-2516
Mailing address
13860 SW Burlwood St
Beaverton, OR 97005-1103
Phone (206) 658-7675
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64940 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1942984380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13860 SW BURLWOOD ST",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970051103",
"telephone_number": "206-658-7675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 NW 18TH AVE STE 400",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972092516",
"telephone_number": "503-228-1306",
"fax_number": "503-228-1307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAR",
"first_name": "EMIKO",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-14",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "64940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.