Marissa L Illingworth, CRM PSS is a
Peer Specialist based in Salem, Oregon. Marissa L Illingworth is licensed to practice in Oregon (license number 22-CRM--1462) and her current practice location is
2045 Silverton Rd Ne, Salem, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 576-4660.
NPI number for Marissa L Illingworth is 1467152413 and her current mailing address is 5189 Dome Rock Ct Se, Salem, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1467152413.
Healthcare Provider's Profile
Full Name | Marissa L Illingworth |
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Gender | Female |
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Speciality | Peer Specialist |
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Location | 2045 Silverton Rd Ne, Salem, Oregon |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1467152413
- Provider Enumeration Date: 03/08/2023
- Last Update Date: 07/17/2024
Medical Identifiers
Medical identifiers for Marissa L Illingworth such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467152413 | NPI | - | NPPES |
T-23-2885 | Other | OR | MHACBO |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | T-23-2885 (Oregon) | Secondary |
175T00000X | Peer Specialist | 22-CRM--1462 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marissa L Illingworth is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Marissa L Illingworth, CRM PSS 5189 Dome Rock Ct Se, Salem, OR 97306-2550 Ph: (503) 851-6279 | Marissa L Illingworth, CRM PSS 2045 Silverton Rd Ne, Salem, OR 97301-0100 Ph: (503) 576-4660 |
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