Individual
KATELYN CUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 546-6377
Mailing address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 546-6377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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