Individual
KATHRYN KIRKMAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3735
Mailing address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-7570
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11-06-44
OR
104100000X
Social Worker
Primary
L6162
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568401347
—
OR
Enumeration date
03/02/2011
Last updated
03/25/2019
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