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General NPI Number Information
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NPI Number | 1629246848
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Entity Type | Individual
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Provider Name | KIM TRIGOSO HARVEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 8383 NE SANDY BLVD STE 205
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City | PORTLAND
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State | OR
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Zip | 97220-4967
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Country | US
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Telephone | 503-253-0964
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3007
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City | PORTLAND
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State | OR
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Zip | 97208-3007
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Country | US
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Telephone | 503-758-2900
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 04-07-18
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L16683
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License Number State | OR
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