Provider Demographics
NPI:1366802795
Name:PALMER, CATHERINE (MS, MFT, NCC, LPC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS, MFT, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8417 N SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-2240
Mailing Address - Country:US
Mailing Address - Phone:503-807-3917
Mailing Address - Fax:
Practice Address - Street 1:811 NW 19TH AVE STE 301B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1401
Practice Address - Country:US
Practice Address - Phone:503-807-3917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-26
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4193101YP2500X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist