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Individual

KRISTINA M BLACKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(503) 747-0404
Mailing address
11340 SW CENTER ST, BEAVERTON, OR 97005-2205
(971) 363-8700

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR

Other

Enumeration date
11/21/2025
Last updated
11/21/2025
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