Basic Information
| Provider Information | |||||||||
| NPI: | 1427359942 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA, LPCI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 912 NE KELLY AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | GRESHAM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970305637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032584481 | ||||||||
| FaxNumber: | 5036672580 | ||||||||
| Practice Location | |||||||||
| Address1: | 912 NE KELLY AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | GRESHAM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970305637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032584481 | ||||||||
| FaxNumber: | 5036672580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2010 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.