Provider Demographics
NPI:1275058976
Name:O'BRIEN, KRISTINE LEANN (LMHC, MS/EDS)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LEANN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMHC, MS/EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 SW US VETERANS HOSPITAL ROAD
Mailing Address - Street 2:ATTN: V3CRS
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-9902
Mailing Address - Country:US
Mailing Address - Phone:360-334-0257
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:360-334-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health