Healthcare Provider Details

I. General information

NPI: 1003653767
Provider Name (Legal Business Name): STEPHANIE KURZENHAUSER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 SW BARNES RD STE 261
PORTLAND OR
97225-6784
US

IV. Provider business mailing address

9135 SW BARNES RD STE 261
PORTLAND OR
97225-6784
US

V. Phone/Fax

Practice location:
  • Phone: 503-216-6300
  • Fax: 971-282-0118
Mailing address:
  • Phone: 503-216-6300
  • Fax: 971-282-0118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL18668
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: