Individual provider · Type 1 NPI

Kimberly Cantonwine, M.A.

Mental Health Counselor · Portland, OR

NPI number 1104232032 Active

Practice location

2415 SE 43rd Ave Ste 200
Portland, OR 97206-1671

Call (503) 238-0705 Map

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XR3328 (OR)
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104232032

Kimberly Cantonwine, M.A.'s National Provider Identifier is 1104232032, issued on Jul 11, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Mar 12, 2020.