Individual
KRISTI KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
(503) 402-2939
Mailing address
PO BOX 1034, P3-WC1, PORTLAND, OR 97207-1034
(503) 220-8262
(503) 402-2939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5264
OR
Other
Enumeration date
10/07/2010
Last updated
09/21/2012
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