Individual
TATUM MARCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4314 N MISSISSIPPI AVE, PORTLAND, OR 97217-3135
(503) 891-9700
Mailing address
PO BOX 83261, PORTLAND, OR 97283-0261
(503) 891-9700
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
144188
CA
106H00000X
Marriage & Family Therapist
MFT-881
HI
106H00000X
Marriage & Family Therapist
Primary
T2394
OR
171100000X
Acupuncturist
AC177186
OR
Other
Enumeration date
09/29/2016
Last updated
11/06/2024
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