Provider Demographics
NPI:1104202811
Name:VOLKMANN, TOREN MITCHELL (MA)
Entity Type:Individual
Prefix:MR
First Name:TOREN
Middle Name:MITCHELL
Last Name:VOLKMANN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 NE MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-3572
Mailing Address - Country:US
Mailing Address - Phone:360-790-5615
Mailing Address - Fax:
Practice Address - Street 1:15 SE 16TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1477
Practice Address - Country:US
Practice Address - Phone:503-308-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist