Individual
KATHERYN CORDOVA JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5932 NE GLISAN ST, PORTLAND, OR 97213-3754
(503) 912-2741
Mailing address
5932 NE GLISAN ST, PORTLAND, OR 97213-3754
(503) 912-2741
(503) 912-2832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L10261
OR
Other
Enumeration date
07/28/2016
Last updated
11/24/2025
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