Healthcare Provider Details

I. General information

NPI: 1326253733
Provider Name (Legal Business Name): SCOTT MARTIN LAFORCE MFT ASSOCIATE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1584 NE 8TH ST STE 200
GRESHAM OR
97030-5746
US

IV. Provider business mailing address

1584 NE 8TH ST STE 200
GRESHAM OR
97030-5746
US

V. Phone/Fax

Practice location:
  • Phone: 971-220-6449
  • Fax: 503-388-3879
Mailing address:
  • Phone: 971-220-6449
  • Fax: 503-388-3879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberR9051
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: