Provider Demographics
NPI:1235384173
Name:BORTZ, MARGARET (MA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BORTZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5873 SW TERWILLIGER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2860
Mailing Address - Country:US
Mailing Address - Phone:541-255-7314
Mailing Address - Fax:
Practice Address - Street 1:2951 NW DIVISION ST STE 200
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5294
Practice Address - Country:US
Practice Address - Phone:503-258-4600
Practice Address - Fax:503-667-2580
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health