Mary Diane Anderson

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

000007279 Issued in OR

Practice address

4110 3Rd St
Tillamook, OR 97141-2804

Phone

(503) 842-2788

NPI assigned

Mar 9, 2013

Last updated

Mar 9, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1362787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362787200000",
    "number": "1992046395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 DOUGLAS AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971412025",
            "telephone_number": "503-354-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 3RD ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971412804",
            "telephone_number": "503-842-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-09",
        "last_updated": "2013-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OR",
            "license": "000007279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aetnia LLC
• Anadelia Aguilar
• Jin Mo Ahn, D.M.D.
• Tammy Ahn
• Jennifer P Allbright, RDH
• Shirley Arneson, ANP
• Daniel Arthur, FNP
• Ashley R Atwood, MS
• Cory Baird
• Linda C Ballard, PMHNP

• Home Health Aide in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Home Health Aide in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2013; 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.