Individual
DEBRA KATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2415 SE 43RD AVE, SUITE 100, PORTLAND, OR 97206
(504) 238-0705
(503) 236-7166
Mailing address
2645 SE OAK GROVE BLVD, MILWAUKIE, OR 97267-1328
(503) 659-4171
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
080-045850N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000693
—
OR
Enumeration date
10/02/2006
Last updated
07/09/2007
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