Individual
KATIE LONGSHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA, CRM II, PSS
Contact information
Practice address
182 SW ACADEMY ST STE 333, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
1960 SE GODSEY RD, DALLAS, OR 97338-2737
(971) 612-1578
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/17/2022
Last updated
05/28/2024
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