MEDICARE: MARNEY ANN HOFFMAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH60500864	WA

General Provider Information

NPI Number	:	1982749735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARNEY ANN HOFFMAN PHD

Provider Business Mailing Address
First Line	:	5037 SW HUMPHREY BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97221-2310
Country	:	US
Telephone Number	:	503-504-5067
Fax Number	:

Provider Business Practice Location Address
First Line	:	5037 SW HUMPHREY BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97221-2310
Country	:	US
Telephone Number	:	503-504-5067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	02/07/2015

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