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General NPI Number Information
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NPI Number | 1992084743
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Entity Type | Individual
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Provider Name | CATHERINE ELIZABETH CHRISTINE ARCHIBALD MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 12/11/2018
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Provider Practice Location Address
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Address Line | 10157 SW BARBUR BLVD STE 107C
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City | PORTLAND
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State | OR
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Zip | 97219-5910
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Country | US
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Telephone | 503-679-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 410 SE 16TH ST
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City | GRESHAM
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State | OR
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Zip | 97080-9322
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Country | US
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Telephone | 503-679-5242
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4042
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License Number State | OR
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