Healthcare Provider Details

I. General information

NPI: 1871408625
Provider Name (Legal Business Name): CHRISTOPHER BARRETT KIRSCHBAUM DOO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 SE 66TH AVE STE 202
PORTLAND OR
97206-2626
US

IV. Provider business mailing address

3506 SE 66TH AVE STE 202
PORTLAND OR
97206-2626
US

V. Phone/Fax

Practice location:
  • Phone: 503-884-9749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberA18848
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number564870
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: