Individual
KATHRYN MACLEOD HEITZHAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
12570 SW 69TH AVE, PORTLAND, OR 97223-2550
(503) 427-2394
Mailing address
PO BOX 16308, PORTLAND, OR 97292-0308
(503) 427-2394
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
3363
OR
103TC0700X
Clinical Psychologist
3363
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2016
Last updated
11/21/2024
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