Individual
DR. MARSHA ANN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
710 E FOOTHILLS DR STE C, SUITE 104, NEWBERG, OR 97132-6125
(503) 728-8546
Mailing address
PO BOX 494, NEWBERG, OR 97132-0494
(503) 728-8546
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60146929
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470798717-26
—
NE
05
—
470798717-27
—
NE
05
—
470798717-29
—
NE
Enumeration date
06/18/2007
Last updated
06/07/2016
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