Individual
DR. ALBERTA KOCH HATTEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1319 SW COLLEGE ST, SUITE 9, PORTLAND, OR 97201-3159
(919) 928-0879
Mailing address
1319 SW COLLEGE ST, PORTLAND, OR 97201-3159
(919) 928-0879
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
LMFT410
NC
106H00000X
Marriage & Family Therapist
MFCC19550
CA
106H00000X
Marriage & Family Therapist
Primary
T0999
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11566
BCBSNC
NC
Enumeration date
07/04/2006
Last updated
03/31/2017
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