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General NPI Number Information
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NPI Number | 1154973139
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Entity Type | Individual
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Provider Name | KATHERINE RAINERI PSYD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 7972 SE 13TH AVE STE 101
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City | PORTLAND
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State | OR
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Zip | 97202-6677
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Country | US
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Telephone | 503-489-8864
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Fax |
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Provider Business Mailing Address
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Address Line | 7972 SE 13TH AVE STE 101
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City | PORTLAND
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State | OR
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Zip | 97202-6677
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Country | US
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Telephone | 503-489-8864
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3077
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3077
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License Number State | OR
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