Provider Demographics
NPI:1467853804
Name:KIRKPATRICK, KATE NICOLE (PDSP)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:NICOLE
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:PDSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 NE MLK JR BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1111
Mailing Address - Country:US
Mailing Address - Phone:503-288-8066
Mailing Address - Fax:503-288-8168
Practice Address - Street 1:3716 NE MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1111
Practice Address - Country:US
Practice Address - Phone:503-288-8066
Practice Address - Fax:503-288-8168
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist