Provider Demographics
NPI:1952065112
Name:OLEMUN, KATHERINE TATOM (CADC-R)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:TATOM
Last Name:OLEMUN
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MAE
Other - Last Name:TATOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:433 3RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2860
Mailing Address - Country:US
Mailing Address - Phone:541-791-7193
Mailing Address - Fax:
Practice Address - Street 1:433 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2860
Practice Address - Country:US
Practice Address - Phone:541-791-7193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor