Individual
KATHERINE VAN BROCKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2923 NE BROADWAY ST, PORTLAND, OR 97232-1760
(564) 225-2450
Mailing address
6259 SE 32ND AVE, PORTLAND, OR 97202-8504
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A14684
OR
104100000X
Social Worker
SC61494846
WA
Other
Enumeration date
03/14/2023
Last updated
07/02/2025
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