Provider Demographics
NPI:1669608055
Name:BUCHHOLZ, KATHERINE ANNE (LMFT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANNE
Last Name:BUCHHOLZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANNE
Other - Last Name:KELLAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4116 NE HASSALO ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2610
Mailing Address - Country:US
Mailing Address - Phone:415-552-5343
Mailing Address - Fax:
Practice Address - Street 1:4225 NE TILLAMOOK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1313
Practice Address - Country:US
Practice Address - Phone:503-298-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-31
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health