Mary Theresa Stites, LMFT
Marriage & Family Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1902932445
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1902932445
- Entity type
- Individual (NPI-1)
- Name
- Mary Theresa Stites
- Credential
- LMFT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 26, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | T0472 | OR | Yes |
Practice location
1500 Ne Irving StSuite 250
Portland, OR 97232-2243
Phone 503-233-4356
Mailing address
19779 Wildwood DrWest Linn, OR 97068-2228
Phone 503-522-3069
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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