Individual
KETKI PATANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9155 SW BARNES RD STE 205, PORTLAND, OR 97225-6629
(503) 216-2025
Mailing address
9155 SW BARNES RD STE 205, PORTLAND, OR 97225-6629
(503) 216-2025
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
C6743
OR
Other
Enumeration date
04/04/2018
Last updated
09/30/2024
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