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General NPI Number Information
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NPI Number | 1851021646
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE COMMUNITY PSYCHOTHERAPY
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 9320 SW BARBUR BLVD STE 380
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City | PORTLAND
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State | OR
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Zip | 97219-5430
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Country | US
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Telephone | 971-204-8925
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Fax |
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Provider Business Mailing Address
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Address Line | 9320 SW BARBUR BLVD STE 380
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City | PORTLAND
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State | OR
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Zip | 97219-5430
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Country | US
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Telephone | 971-204-8925
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ESTHER SEXTON
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Credential | PSYD
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Telephone | 971-312-9254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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