Individual
KIM A WATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
325 NW 21ST AVE, SUITE 203, PORTLAND, OR 97209-1174
(503) 880-3288
Mailing address
325 NW 21ST AVE, SUITE 203, PORTLAND, OR 97209-1174
(503) 880-3288
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/12/2006
Last updated
03/13/2008
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