Individual
MRS. KATHLEEN GRACE CONVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 SE SANDY BLVD STE 100, PORTLAND, OR 97214-1399
(503) 427-1952
Mailing address
5234 N OBERLIN ST, PORTLAND, OR 97203-4327
(509) 432-5364
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
03/24/2021
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