Provider Demographics
NPI:1780853036
Name:HOCK, MARY CHRISTINE
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:HOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:HOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:7415 N OATMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-1213
Mailing Address - Country:US
Mailing Address - Phone:503-224-0223
Mailing Address - Fax:503-288-0943
Practice Address - Street 1:7415 N OATMAN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-1213
Practice Address - Country:US
Practice Address - Phone:503-224-0223
Practice Address - Fax:503-288-0943
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional