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Individual

LOIS A MARBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRM

Contact information

Practice address
355 NW DIVISION ST, GRESHAM, OR 97030-5523
(971) 225-6695
(503) 231-1654
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(503) 621-2235

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21-CRM-344
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500811874
OR
Enumeration date
03/09/2021
Last updated
09/22/2025
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