Provider Demographics
NPI:1336327089
Name:PADULO, MOLLY KATHLEEN (MA)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:KATHLEEN
Last Name:PADULO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1962 NW KEARNEY ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1400
Mailing Address - Country:US
Mailing Address - Phone:503-358-6945
Mailing Address - Fax:
Practice Address - Street 1:1962 NW KEARNEY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1400
Practice Address - Country:US
Practice Address - Phone:503-358-6945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health