Healthcare Provider Details

I. General information

NPI: 1356620538
Provider Name (Legal Business Name): KATHRYN HULSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2011
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12636 SE STARK ST BLDG J
PORTLAND OR
97233-1058
US

IV. Provider business mailing address

427 PAJARO STREET UPSTAIRS SUITES 1,2,3
SALINAS CA
93901
US

V. Phone/Fax

Practice location:
  • Phone: 503-253-4600
  • Fax:
Mailing address:
  • Phone: 800-214-5439
  • Fax: 831-796-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100133
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberC8421
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number126125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: