MEDICARE: KATELYN BESSETTE

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor	3786	OR
4	101YP2500X	Professional Counselor	C3786	OR

General Provider Information

NPI Number	:	1699029199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN BESSETTE

Provider Business Mailing Address
First Line	:	2621 SE 36TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-1519
Country	:	US
Telephone Number	:	503-858-7073
Fax Number	:

Provider Business Practice Location Address
First Line	:	2621 SE 36TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-1519
Country	:	US
Telephone Number	:	503-858-7073
Fax Number	:

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

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	07/15/2025

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Directions to “ KATELYN BESSETTE ” Practice Location

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