Healthcare Provider Details

I. General information

NPI: 1417871682
Provider Name (Legal Business Name): MYRKA GUZMAN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20019 SW SQUIRE DR
BEAVERTON OR
97007-7497
US

IV. Provider business mailing address

20019 SW SQUIRE DR
BEAVERTON OR
97007-7497
US

V. Phone/Fax

Practice location:
  • Phone: 503-706-8157
  • Fax:
Mailing address:
  • Phone: 503-706-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberSTB-IN-10259857
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: