MEDICARE: MAUREEN THERESE MARKEY M.S.

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

General Provider Information

NPI Number	:	1952445280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN THERESE MARKEY M.S.

Provider Business Mailing Address
First Line	:	4834 NE 26TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-6319
Country	:	US
Telephone Number	:	503-281-8177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 NE IRVING ST
Second Line	:	SUITE 250
City	:	PORTLAND
State	:	OR
Zip	:	97232-2243
Country	:	US
Telephone Number	:	503-233-4356
Fax Number	:

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/08/2007

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