Provider Demographics
NPI:1275033268
Name:DOERFLER, MARNI LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARNI
Middle Name:LYNN
Last Name:DOERFLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SW 5TH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5537
Mailing Address - Country:US
Mailing Address - Phone:877-943-2507
Mailing Address - Fax:503-346-8019
Practice Address - Street 1:51377 SW OLD PORTLAND RD
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-4023
Practice Address - Country:US
Practice Address - Phone:503-418-4222
Practice Address - Fax:503-418-4223
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL77291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical