Provider Demographics
NPI:1568899128
Name:HOUGHTON, MARY KATHERINE (MS, MA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:FREESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MA
Mailing Address - Street 1:3306 SE 75TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-2406
Mailing Address - Country:US
Mailing Address - Phone:503-314-7504
Mailing Address - Fax:
Practice Address - Street 1:2020 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-2345
Practice Address - Country:US
Practice Address - Phone:503-233-6121
Practice Address - Fax:503-233-6126
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst