Provider Demographics
NPI:1215165006
Name:COLACO, CLAIRE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:
Last Name:COLACO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3519 NE 15TH AVE # 461
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2356
Mailing Address - Country:US
Mailing Address - Phone:971-259-8284
Mailing Address - Fax:
Practice Address - Street 1:2240 N INTERSTATE AVE STE 290
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1773
Practice Address - Country:US
Practice Address - Phone:650-617-3867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54203106H00000X
CAMFC 49639106H00000X
ORT0910106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist