Individual
KRISTEN ANN GENZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8885 SW CANYON RD STE 215, PORTLAND, OR 97225-3429
(971) 712-6260
Mailing address
5126 NE 32ND AVE, PORTLAND, OR 97211-6940
(480) 250-5932
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178.011112
IL
101YM0800X
Mental Health Counselor
LH60665316
WA
101YP2500X
Professional Counselor
Primary
C4447
OR
Other
Enumeration date
06/22/2016
Last updated
04/06/2022
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