Provider Demographics
NPI:1750437943
Name:WHITE, MARSHA LORRAINE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:LORRAINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82431
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-0431
Mailing Address - Country:US
Mailing Address - Phone:503-246-0408
Mailing Address - Fax:503-232-5443
Practice Address - Street 1:0333 SW FLOWER ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3754
Practice Address - Country:US
Practice Address - Phone:503-236-0408
Practice Address - Fax:503-232-5443
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
11645641OtherCAQH