Individual
DR. KATHLEEN IRENE WOODSIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2153 SW MAIN ST, 104, PORTLAND, OR 97205-1124
(503) 454-6784
Mailing address
2153 SW MAIN ST, 104, PORTLAND, OR 97205-1124
(503) 454-6784
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2572
OR
103TC0700X
Clinical Psychologist
018322
NY
Other
Enumeration date
10/14/2009
Last updated
09/14/2016
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