Provider Demographics
NPI:1306546502
Name:HORGAN AREVALO, KARLA FABIOLA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:FABIOLA
Last Name:HORGAN AREVALO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:AREVALO DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1473
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97075-1473
Mailing Address - Country:US
Mailing Address - Phone:503-376-9520
Mailing Address - Fax:
Practice Address - Street 1:10445 SW CANYON RD STE 119B
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1938
Practice Address - Country:US
Practice Address - Phone:503-376-9520
Practice Address - Fax:971-223-0903
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health