Provider Demographics
NPI:1215527213
Name:RIVENBURGH, RAINER QUINN CATKIN (MAAT, ATR-BC, LPC)
Entity type:Individual
Prefix:
First Name:RAINER
Middle Name:QUINN CATKIN
Last Name:RIVENBURGH
Suffix:
Gender:M
Credentials:MAAT, ATR-BC, LPC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:QUINN
Other - Last Name:RIVENBURGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7805 SW 40TH AVE # 80172
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3905 SW VACUNA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-7471
Practice Address - Country:US
Practice Address - Phone:206-605-6208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC6010101YM0800X, 101YM0800X
ORART-T-10209883221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist