MEDICARE: KATHERYNE LEWIS LMHC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	C8703	OR
2	101YM0800X	Mental Health Counselor	C8703	OR

General Provider Information

NPI Number	:	1396338463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERYNE LEWIS LMHC, LPC

Provider Business Mailing Address
First Line	:	3930 N MONTANA AVE UNIT 4
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1285
Country	:	US
Telephone Number	:	503-908-4376
Fax Number	:	855-469-3430

Provider Business Practice Location Address
First Line	:	3930 N MONTANA AVE UNIT 4
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1285
Country	:	US
Telephone Number	:	503-908-4376
Fax Number	:	855-469-3430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	10/04/2024

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