Provider Demographics
NPI:1982749735
Name:HOFFMAN, MARNEY ANN (PHD)
Entity Type:Individual
Prefix:
First Name:MARNEY
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARNEY
Other - Middle Name:ANN
Other - Last Name:SCHLECHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5037 SW HUMPHREY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2310
Mailing Address - Country:US
Mailing Address - Phone:503-504-5067
Mailing Address - Fax:
Practice Address - Street 1:5037 SW HUMPHREY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2310
Practice Address - Country:US
Practice Address - Phone:503-504-5067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60500864101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health