Provider Demographics
NPI:1679024327
Name:MARNEY HOFFMAN, PHD
Entity Type:Organization
Organization Name:MARNEY HOFFMAN, PHD
Other - Org Name:HOFFMAN BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/BEHAVIORAL HEALTH COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-504-5067
Mailing Address - Street 1:1133 NW 21ST AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1513
Mailing Address - Country:US
Mailing Address - Phone:503-504-5067
Mailing Address - Fax:
Practice Address - Street 1:1133 NW 21ST AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1513
Practice Address - Country:US
Practice Address - Phone:503-504-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty