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General NPI Number Information
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NPI Number | 1922897743
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Entity Type | Individual
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Provider Name | KATHARINE BERENSON SELAH
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Gender | Female
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1800 SW 1ST AVE STE 400
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City | PORTLAND
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State | OR
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Zip | 97201-5355
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Country | US
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Telephone | 917-951-1437
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 SW 1ST AVE STE 400
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City | PORTLAND
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State | OR
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Zip | 97201-5355
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Country | US
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Telephone | 971-251-9856
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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