Provider Demographics
NPI:1164559423
Name:ALEXANDRE, KATHERINA I (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHERINA
Middle Name:I
Last Name:ALEXANDRE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHERINA
Other - Middle Name:
Other - Last Name:ALEXANDRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 1823
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070
Mailing Address - Country:US
Mailing Address - Phone:503-890-2454
Mailing Address - Fax:503-961-7831
Practice Address - Street 1:4450 LORDS LN
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-6532
Practice Address - Country:US
Practice Address - Phone:503-890-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YP2500X
ORTO533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional