| Katherine Calvert Llc | |
|
4531 Se Belmont St Suite 203 Portland OR 97215-1675 | |
| (503) 705-2194 | |
| (503) 841-5816 |
| Full Name | Katherine Calvert Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4531 Se Belmont St, Portland, Oregon |
| Authorized Official Name and Position | Katherine Yerxa Calvert (OWNER) |
| Authorized Official Contact | 5037052194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Calvert Llc 4531 Se Belmont St Suite203 Portland OR 97215-1675 Ph: (503) 705-2194 | Katherine Calvert Llc 4531 Se Belmont St Suite 203 Portland OR 97215-1675 Ph: (503) 705-2194 |
| NPI Number | 1124343827 |
|---|---|
| Provider Enumeration Date | 04/06/2010 |
| Last Update Date | 04/21/2017 |
| Medicare PECOS PAC ID | 8527251222 |
|---|---|
| Medicare Enrollment ID | O20101026000135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124343827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | OR L3275 (Oregon) | Primary |
| Provider Name | Katherine Y Calvert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326096512 PECOS PAC ID: 3274543111 Enrollment ID: I20060421000485 |
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