Provider Demographics
NPI:1972728277
Name:JANSEN-BYRKIT, KATHERINE MAY (MPH, LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MAY
Last Name:JANSEN-BYRKIT
Suffix:
Gender:F
Credentials:MPH, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 RIDGE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-7576
Mailing Address - Country:US
Mailing Address - Phone:503-267-6049
Mailing Address - Fax:
Practice Address - Street 1:04 SW HAMILTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4095
Practice Address - Country:US
Practice Address - Phone:503-267-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1998101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional