{
"Npi": {
"NPI": "1154632206",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARKS",
"FirstName": "DAVID",
"MiddleName": "C",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "MA MFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2 JEFFERSON PKWY",
"SecondLineMailingAddress": "#H2",
"MailingAddressCityName": "LAKE OSWEGO",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97035-8879",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-360-5117",
"MailingAddressFaxNumber": "503-719-8987",
"FirstLinePracticeLocationAddress": "0333 SW FLOWER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORTLAND",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97239-3754",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-349-2281",
"PracticeLocationAddressFaxNumber": "503-719-8987",
"EnumerationDate": "06/23/2010",
"LastUpdateDate": "02/10/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFC 48474",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "T1242",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}