Individual
MS. KATHERINE LEIGH BOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS, THW, QMHA
Contact information
Practice address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
(503) 666-6575
Mailing address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
(503) 666-6575
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
THW0648
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW0648
PEER SUPPORT SPECIALIST- ADULT MENTAL HEALTH
OR
Enumeration date
09/22/2017
Last updated
07/21/2022
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