Healthcare Provider Details

I. General information

NPI: 1609982339
Provider Name (Legal Business Name): KATHERINE SOYARS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10060 NE EVERGREEN PKWY OFC
HILLSBORO OR
97124-6448
US

IV. Provider business mailing address

10060 NW EVERGRN PKWY
HILLSBORO OR
97124-6448
US

V. Phone/Fax

Practice location:
  • Phone: 971-310-2538
  • Fax:
Mailing address:
  • Phone: 971-310-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2774
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: