Individual
KATHRYN R RIDGEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
51377 SW OLD PORTLAND RD, SCAPPOOSE, OR 97056
(503) 418-4222
(503) 418-4223
Mailing address
51377 SW OLD PORTLAND RD, SCAPPOOSE, OR 97056-4023
(503) 418-4222
(503) 418-4223
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CANDIDATE
OR
104100000X
Social Worker
LSW.0009921498
CO
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L8005
OR
Other
Enumeration date
10/10/2012
Last updated
04/28/2021
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