MR. MARK WILLIAM DOUGLASS LPC
NPI 1023283660
Counselor - Professional in Clackamas, OR

Q: What is Mark Douglass's NPI number?

The NPI number for Mark Douglass is 1023283660. It was assigned to this individual provider in the NPPES registry on April 24, 2008.

Q: What is Mark Douglass's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Mark Douglass was last updated on November 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 24, 2008PECOS Enrolled

10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015(503) 517-0878(503) 517-0866 Get Directions Write a Review

NPPES record last updated: November 24, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 24, 2023, Oct 22, 2021 (2 updates tracked since 2021).

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About Mr. Mark William Douglass Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARK WILLIAM DOUGLASS LPC (NPI 1023283660) is an individual professional provider in Clackamas, Oregon, licensed in Oregon (C2839) and active in the NPI registry since April 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023283660

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. MARK WILLIAM DOUGLASSCredential: LPC

Location Address10180 SE SUNNYSIDE RDClackamas, OR 97015-8970

Mailing Address10180 Se Sunnyside RdClackamas, OR 97015-8970 · (503) 571-0878 · Fax (503) 517-0866

Phone(503) 517-0878

Fax(503) 517-0866

Sole ProprietorYes

Enumeration DateApril 24, 2008

Last NPPES UpdateNovember 24, 20232 updates tracked since enumeration

NPPES CertifiedNovember 24, 2023

✔ NPI 1023283660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OR · C2839

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 18-03-14 (OR)

10180 SE SUNNYSIDE RD, Clackamas, OR 97015

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Mark William Douglass Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DANIEL FORREST LOTSPEICH MD

Internal Medicine

10180 SE SUNNYSIDE RD, KAISER PERMANENTE DEPARTMENT OF INTERNAL MEDICINE
CLACKAMAS, OR 97015

Clackamas County (503) 652-2880

MEGAN LEA KELLY

Emergency Medicine

10180 SE SUNNYSIDE RD, KAISER SUNNYSIDE MEDICAL CENTER
CLACKAMAS, OR 97015

Clackamas County (503) 652-2880

JARROD L LARSON M.D.

Anesthesiology