Provider Demographics
NPI:1275133753
Name:HARKNESS, PATRICIO JAVIER (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIO
Middle Name:JAVIER
Last Name:HARKNESS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:PATRICIO
Other - Middle Name:JAVIER
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1411 NE 16TH AVE APT S122
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-4407
Mailing Address - Country:US
Mailing Address - Phone:850-570-6885
Mailing Address - Fax:
Practice Address - Street 1:3500 NE MLK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2093
Practice Address - Country:US
Practice Address - Phone:503-327-8205
Practice Address - Fax:971-254-4882
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5873101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional