Provider Demographics
NPI:1871815662
Name:LINK, KRISTEN D (MSW, QMHP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:D
Last Name:LINK
Suffix:
Gender:F
Credentials:MSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 PORTLAND RD NE STE 120
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0200
Mailing Address - Country:US
Mailing Address - Phone:971-218-0994
Mailing Address - Fax:
Practice Address - Street 1:2645 PORTLAND RD NE STE 120
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0200
Practice Address - Country:US
Practice Address - Phone:971-218-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health