Wood, Katherine L
Wood, Katherine L is an individual health care provider with primary practice located at 2808 Ne Martin Luther King Blvd Ste M , Portland OR 97212-3061. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Wood, Katherine L can be contacted via phone (971) 270-0535.Contact Information
Primary practice address
2808 Ne Martin Luther King Blvd Ste M
Portland OR 97212-3061
Phone: (971) 270-0535
Fax: (971) 369-9809
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 23-QMHP-R-2005 | Oregon |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist | 221700000X | ||
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | R8611 | Oregon |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | MC61466384 | Washington |
Profile Details
| NPI number | 1245962653 |
|---|---|
| LBN Legal business name | Wood, Katherine L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2022 |
| Last updated | Nov 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245962653 | NPPES |
| Oregon | MEDICAID | 500820108 |
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