Provider Demographics
NPI:1205440500
Name:CHRISTENSEN, MARLA (LPC)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11969 SW LAUSANNE ST
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-7328
Mailing Address - Country:US
Mailing Address - Phone:503-522-6355
Mailing Address - Fax:
Practice Address - Street 1:18650 SW BOONES FERRY RD STE 3
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8491
Practice Address - Country:US
Practice Address - Phone:503-850-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC-5752106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist