Provider Demographics
NPI:1639980519
Name:KATZ, MARJORIE (MA)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:KATZ
Suffix:
Gender:X
Credentials:MA
Other - Prefix:
Other - First Name:MAXX
Other - Middle Name:
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:4812 NE GOING ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-2004
Mailing Address - Country:US
Mailing Address - Phone:434-882-4239
Mailing Address - Fax:
Practice Address - Street 1:825 NE 20TH AVE STE 250
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2282
Practice Address - Country:US
Practice Address - Phone:434-882-4239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor