Healthcare Provider Details

I. General information

NPI: 1194612283
Provider Name (Legal Business Name): MARQUITA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N DIXON ST
PORTLAND OR
97227-1876
US

IV. Provider business mailing address

501 N DIXON ST
PORTLAND OR
97227-1876
US

V. Phone/Fax

Practice location:
  • Phone: 971-222-6230
  • Fax:
Mailing address:
  • Phone: 971-222-6230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number119117
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: