Individual
KATIE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
1184 MCGEE CT NE, KEIZER, OR 97303-9443
(503) 304-4358
(503) 304-4361
Mailing address
PO BOX 20674, KEIZER, OR 97307-0674
(503) 304-4358
(503) 304-4361
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18-04-07
OR
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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