Kristen M. White | Portland, OR • PECOS Search

Kristen M. White

Counselor

Behavioral Health & Social Service Providers

8435 NE Glisan Street, Portland, OR 97220

PECOS Enrollment

Based on the most recent information from CMS, provider Kristen M. White does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1821281072
Provider Type
Individual
Full Name
White, Kristen M.
Title
Dr.
Credential
PSY.D.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/21/2007
Last Updated
10/12/2023

Contact Information

Practice Location

8435 NE Glisan Street, Portland, OR 97220

Unlisted Fax

Mailing Location

8435 NE Glisan Street, Portland, OR 97220

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer