Provider Demographics
NPI:1578755443
Name:DEMARCO, DEBORAH LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4511 SE HAWTHORNE BLVD
Mailing Address - Street 2:STE 114
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3170
Mailing Address - Country:US
Mailing Address - Phone:503-232-6868
Mailing Address - Fax:503-232-8197
Practice Address - Street 1:4511 SE HAWTHORNE BLVD
Practice Address - Street 2:STE 114
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3170
Practice Address - Country:US
Practice Address - Phone:503-232-6868
Practice Address - Fax:503-232-8197
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0387101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor