Provider Demographics
NPI:1326096512
Name:CALVERT, KATHERINE YERXA (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:YERXA
Last Name:CALVERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 SW MURRAY BLVD # 199
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-4421
Mailing Address - Country:US
Mailing Address - Phone:503-705-2194
Mailing Address - Fax:866-617-1750
Practice Address - Street 1:13140 SW HEATHER CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-5612
Practice Address - Country:US
Practice Address - Phone:503-705-2194
Practice Address - Fax:866-617-1750
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL32751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134503Medicare PIN