Individual
CHRISTINA W. ENTICKNAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2512 SE 25TH AVE STE 202, PORTLAND, OR 97202-2075
(503) 544-3201
Mailing address
2512 SE 25TH AVE STE 202, PORTLAND, OR 97202-2075
(503) 544-3201
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1966
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500676083
—
OR
01
—
C1966
OREGON BOARD OF LICENSED PROFESSIONAL COUNSELORS AN
OR
Enumeration date
01/24/2007
Last updated
10/31/2023
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