Individual
KRISTINE MIDYETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
621 SW ALDER ST, SUITE 400, PORTLAND, OR 97205-3626
(800) 435-2197
Mailing address
621 SW ALDER ST, SUITE 400, PORTLAND, OR 97205-3626
(800) 435-2197
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5949
OR
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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