Individual
KATHRYN ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LPC
Contact information
Practice address
1700 NW CIVIC DR STE 310, GRESHAM, OR 97030-3774
(503) 666-8832
Mailing address
1700 NW CIVIC DR STE 310, GRESHAM, OR 97030-3774
(503) 666-8832
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C4913
OR
101YP2500X
Professional Counselor
Primary
C4913
OR
Other
Enumeration date
05/11/2013
Last updated
03/13/2026
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