Provider Demographics
NPI:1639187099
Name:HOFFMAN, GINNA ALENE (MA, MFT, LPC)
Entity Type:Individual
Prefix:
First Name:GINNA
Middle Name:ALENE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MA, MFT, LPC
Other - Prefix:
Other - First Name:GINNA
Other - Middle Name:ALENE
Other - Last Name:MARLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2951 NW DIVISION ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5292
Mailing Address - Country:US
Mailing Address - Phone:503-928-2999
Mailing Address - Fax:503-667-2580
Practice Address - Street 1:2951 NW DIVISION ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5292
Practice Address - Country:US
Practice Address - Phone:503-928-2999
Practice Address - Fax:503-667-2580
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 42512106H00000X
ORC2183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist