Individual
KATHY A ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMHC
Contact information
Practice address
4536 NE 116TH AVE, PORTLAND, OR 97220-1419
(503) 833-2652
Mailing address
806 NE 197TH AVE, PORTLAND, OR 97230-7972
(503) 833-2652
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60224180
WA
101YP2500X
Professional Counselor
Primary
C2697
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12306439
CAQH
OR
01
—
C2697
LPC
OR
01
—
LH60224180
LMHC
WA
Enumeration date
11/27/2011
Last updated
11/27/2011
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