Individual
MS. KATHERIN THOMSON VAN DOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA COUNSELING ART TX
Contact information
Practice address
4790 N LOMBARD ST, MORRISON CENTER, PORTLAND, OR 97203-4565
(503) 258-4557
Mailing address
1315 SE 35TH AVE, PORTLAND, OR 97214-4235
(916) 212-2258
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
01/23/2009
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