Individual
EMMA R MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA-I
Contact information
Practice address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
24-QMHA-I-004246
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500791871
—
OR
Enumeration date
04/20/2021
Last updated
04/03/2025
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