Individual
COURTNEY A WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC INTERN, CHT
Contact information
Practice address
2951 SE TAYLOR ST, PORTLAND, OR 97214-4032
(503) 453-4807
Mailing address
PO BOX 15142, PORTLAND, OR 97293-5142
(503) 453-4807
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
R6874
OR
101YM0800X
Mental Health Counselor
R6874
OR
101YP2500X
Professional Counselor
Primary
R6874
OR
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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