Provider Demographics
NPI:1205192226
Name:BAUMAN-VIRNIG, CATHERINE LYDIA (MS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LYDIA
Last Name:BAUMAN-VIRNIG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12901 SE 97TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7901
Mailing Address - Country:US
Mailing Address - Phone:503-655-8045
Mailing Address - Fax:503-655-6806
Practice Address - Street 1:12901 SE 97TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-7901
Practice Address - Country:US
Practice Address - Phone:503-655-8045
Practice Address - Fax:503-655-6806
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor